British journal of nursing (Mark Allen Publishing)最新文献

Background: The insertion of a PIVC is the most commonly performed invasive procedure in healthcare. Despite its frequency in placement in hospitalized patients, PIVCs are generally perceived as being safe; however, the prevalence of failure ranges from 35%-50%. Additionally, complications are common and often deemed 'acceptable' by clinicians. Healthcare provider and clinician foundational knowledge and competency is lacking nationally. Considering the mere volume of PIVCs placed, the failure and complication rates, the human impact is significant.

Methods: The Association for Vascular Access (AVA) has led a collaborative effort with representatives from the Infusion Nurses Society (INS), the American Association of Critical Care Nurses (AACN), ECRI, and content experts representing nursing vascular access, infusion therapy, infection prevention, critical care, pediatrics, healthcare leadership, a physician, and a patient representative. Our aim is to provide concise guidance that will enhance and standardize practices related to PIVC. By consolidating current standards of practice into a comprehensive document, our framework seeks to advance the quality of care and improve patient safety.

Results: This document has undergone meticulous scrutiny to ensure its quality, including incorporation of current standards, methodology for consensus from the expert panel, and input received from public comments.

Conclusions: We anticipate that this work will have a significant impact on healthcare professionals, policymakers, and, most importantly, patients' experiences by the promotion of consistent, high-quality treatment, safety, and comfort for patients receiving a PIVC.

John Tingle, Associate Professor, Birmingham Law School, University of Birmingham, discusses several recently published patient safety reports.

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, reports on research that explored the views and experiences of overseas nurses with advanced practice qualifications working in the UK.

Health literacy is defined as an individual's ability to access, understand and use information to make informed decisions. This study aimed to assess health literacy levels and explore the relationship between health literacy and chronic obstructive pulmonary disease (COPD) severity. A cross-sectional study of health literacy in patients with COPD used the Health Literacy Questionnaire (HLQ) and the Medical Research Council Breathlessness Scale to assess COPD severity. HLQ domains of 'having sufficient information to manage my health', 'actively managing health', and 'understanding health information' scored most highly. Patients with the greatest COPD severity had lower scores in the domain 'having sufficient information to manage my health', but indicated an improved ability to appraise health information. Patients with increased COPD severity have greater self-reported skills in appraising health information, but they report reduced confidence in having sufficient information to manage their health. This study highlights the importance of considering health literacy levels, as this could be a barrier to successful self-management.

Skin problems are common, affecting up to one-third of the population during their lifetime, and they are frequently encountered by advanced clinical practitioners (ACPs) in both primary and secondary care settings. Despite the prevalence of dermatological presentations, ACPs often feel unprepared to conduct a thorough dermatological history and examination. This article aims to provide guidance to trainees and qualified ACPs, whether in acute hospital settings or primary care, to perform dermatological assessments and examinations systematically. This is the first article in a two-part series on dermatological assessment.

In our continuing series on the experiences of a nursing student, Jade Petchey provides some suggestions for keeping your mental and physical health on track.

Introduction: The aim of this observational study was to investigate the risk factors of a failed first attempt at pediatric central venous catheter (CVC) placement and its impact on CVC-related morbidity.

Materials and methods: In this prospective observational study, we included 3-month-to 5-year-old children proposed for infraclavicular subclavian vein catheterization consecutively sing the anatomic landmark technique. Patients were divided into two groups: group 1 included single-attempt catheter placements, and Group 2 included failed first attempts at catheter placement. The management protocol was standardized for all patients. After comparing the two groups, univariable logistic regression was used to investigate the risk factors for a failed first attempt and to show the interest of the single-attempt catheter placement.

Results: Among 150 pediatric CVC placements, the incidence of failed first attempts was 41.3% and its main risk factors were children with comorbidities (OR=3.11; 95%CI: 1.17-8.21), hematology and oncology patients (OR=5.6; 95%CI: 2.75-11.38), children with aplastic anemia (OR=3.05; 95%CI:1.388-6.705), and anesthesia sedation with I-Gel airway ventilation (OR=9.21; 95%CI: 1.080-78.5). On the other hand, a single-attempt catheter placement was a protective factor against catheter-related complications with OR=0.258 [0.12-0.55].

Conclusion: It seems that a single-attempt CVC placement may reduce the incidence of complications. The knowledge of the main risk factors of failed first attempts is mandatory for taking necessary precautions.

Background: Administration of intermittent medication through intravenous infusions is common practice. However, recent literature questions whether current practices deliver full doses of prescribed medications.

Objective: This protocol outlines the methodology intended to profile literature describing management of residual volume in medication administration lines.

Methods: The proposed review will use Joanna Briggs Institute scoping review methodology to scope the literature, following a six-step framework. Searches will be conducted in electronic databases, and websites of societies providing guidelines for intravenous therapy. Three reviewers will use the 'PCC' framework to carry out two levels of screening. Results will be tabulated, described, and discussed in a narrative analysis.

Conclusion: This review will improve understanding of current practices by examining flushing procedures used in the management of residual volume, identifying instances when residual volume is discarded, documenting effects on dosing, examining the impact on patient outcomes, and examining possible environmental harm from waste disposal of undelivered medication.