血管通路专科服务对住院儿科患者的影响:可行性试点研究

Dayna Holt, Theresa Dodd-Butera, Melissa Stebel, Haylie Lichtenberger, Elizabeth Sharpe
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摘要

我们实施 VAST 的项目取得了这些改进成果。静脉注射装置减少了 31%。针刺减少了 22%。延误时间减少了 49%。 血管通路对住院儿科患者的护理至关重要。规划和设备选择对于患者获得最佳治疗效果非常重要。保护血管对儿科患者至关重要。 确定并评估血管通路小组对儿科患者护理的影响。 一家三级儿童医院的一个医疗单元成立了血管通路专家小组(VAST),每天工作 16 小时,为期 4 周。 采用的描述性统计包括:(a) 首次针刺成功率;(b) 每次住院针刺和血管通路装置的数量;(c) 治疗延迟;(d) 局部镇痛剂的使用频率。干预前的数据与干预后的数据进行了比较。对护理人员和医务人员进行了定性调查,以评估他们对项目经验的看法。 与干预前的数据相比,住院期间启动外周静脉管路的次数减少了 56%,使用血管通路总装置的次数减少了 31%。每次尝试外周静脉置管的针刺次数减少了 22%。VAST 的首次针刺成功率为 71%,而床边护士的成功率为 52%。设备之间的间隔时间减少了 78%/1000 病人日/周,这表明治疗中断的情况有所减少。用于静脉装置置入的局部麻醉剂使用率提高了 333%。 该项目明确了 VAST 对儿科住院患者的价值。VAST 模式以证据为基础,遵循最佳实践指南,具有良好的财务效益,并能优化护理实践和病人护理质量。
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Impact of a Vascular Access Specialty Service on Hospitalized Pediatric Patients: A Pilot Feasibility Study
Our project implementing a VAST produced these improved outcomes. There were 31% fewer IV devices. There were 22% fewer needle sticks. There were 49% reduction in delays. Vascular access is essential in the care of hospitalized pediatric patients. Planning and device selection are important for optimal patient outcomes. Vessel preservation is critical for pediatric patients. To determine and evaluate the impact of a vascular access team on pediatric patient care. A vascular access specialist team (VAST) was implemented on one medical unit at a tertiary children’s hospital, 16 hours a day for 4 weeks. Descriptive statistics were used, including (a) first-stick success rates, (b) number of needle sticks and vascular access devices per hospital stay, (c) delays in therapy, and (d) frequency of topical analgesic use. Preintervention data were compared with postintervention data. Qualitatively, nursing and medical staff were surveyed to evaluate their perception of project experiences. Compared with preintervention data, 56% fewer peripheral intravenous lines were initiated, and 31% fewer total vascular access devices were used during the hospital stay. There were 22% fewer needle sticks per peripheral intravenous line attempt. The first-stick success rate of the VAST was 71% compared with the bedside nurse rate of 52%. There was a 78% reduction in time between devices/1000 patient-days/week, representing reduced interruptions in therapy. The use of topical anesthetics for intravenous device placement increased 333%. This project provided clarity regarding the value of the VAST for pediatric hospitalized patients. The VAST model is evidence based, follows best-practice guidelines, is fiscally sound, and optimizes nursing practice and quality patient care.
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