Adherence to vascular access and infusion therapy guidelines
The aim of this cluster randomised trial was to investigate the effects of implementing a clinical practice guideline (CPG) for peripheral venous catheters (PVCs) in paediatric care in the format of reminders integrated in the EPRs, on PVC-related complications, and on registered nurses’ (RNs’) self-reported adherence to the guideline” Förberg et al (2016). Abstract: BACKGROUND: […]
Midline catheters for fast and reliable peripheral venous access
In our experience, 8- to 10-cm-long polyurethane catheters may offer a fast and reliable peripheral venous access in the emergency department, if placed by ultrasound guidance and with the Seldinger technique” Scoppettuolo et al (2016). Abstract: BACKGROUND: Acutely ill patients admitted to the emergency department (ED) constantly require at least one fast and reliable peripheral […]
What are the economic benefits of an OPAT service
Management of cellulitis represents a substantial cost burden for hospital services. Modest per-day cost savings from HITH can be offset by much longer HITH LOS” Kameshwar et al (2016). Abstract: Objectives: The majority of healthcare costs accrued managing cellulitis can be attributed to the small proportion of patients treated with parenteral antibiotics. Hospital in the […]
Which arm and vein should you use for successful PICC insertion
We investigated which arm and vein led to the most successful outcomes during non-fluoroscopic peripherally inserted central catheter (PICC) insertion” Jeon et al (2016). Abstract: OBJECTIVE: We investigated which arm and vein led to the most successful outcomes during non-fluoroscopic peripherally inserted central catheter (PICC) insertion. [ctt tweet=”ReTweet if useful… Which arm and vein should […]
PICC and CICVC associated upper extremity deep vein thrombosis
Our trial demonstrates that critically ill neurologic patients who require a central venous catheter have significantly lower odds of ultrasound-diagnosed CRLVT with placement of a CICVC as compared to a PICC” Fletcher et al (2016). Abstract: BACKGROUND: Observational studies suggest peripherally inserted central venous catheters (PICCs) are associated with a high risk of catheter-related large […]
How to learn ultrasound-guided central venous catheter insertion
As simulation further augments clinical learning, efforts should be made to modify the curricular and bedside factors that facilitate transfer of skills from simulation to practice settings” Mema and Harris (2016). Abstract: PHENOMENON: Ultrasound (US) guided Central Venous Line (CVL) insertion is currently the standard of care. Randomized Controlled Trials (RCTs) and systematic reviews show […]
Needleless connector weekly change prompted by color-coded labels
This study examined nurses’ adherence to policies regarding needleless connector changes using a novel, day-of-the-week, color-coded label compared with usual care that relied on electronic medical record (EMR) documentation” Morrison et al (2016). Abstract: PURPOSE: This study examined nurses’ adherence to policies regarding needleless connector changes using a novel, day-of-the-week, color-coded label compared with usual […]
Improving axillary vein puncture with ultrasound-assistance and arm position
These findings suggest that a 90° abduction of the arm, particularly if associated with a forward position of the shoulder, facilitates the visualization of the axillary vein, making its ultrasound-guided venipuncture easier” Pittiruti et al (2015). Abstract: PURPOSE: Placement of central venous catheters by the infraclavicular route can be achieved by ultrasound-guided puncture of the […]
rt-PA catheter locking solution protocol to treat CVC occlusion
Catheter locking solutions such as recombinant tissue plasminogen activator (rt-PA) are used to treat and prevent clotting of hemodialysis (HD) catheters during HD treatments and the interdialytic period” Wilson et al (2016). Abstract: PURPOSE: Catheter locking solutions such as recombinant tissue plasminogen activator (rt-PA) are used to treat and prevent clotting of hemodialysis (HD) catheters […]
Axillary vein as an alternative method of central venous cannulation
We developed the new technique of the axillary vein catheterization, which is connected with the determination of only two anatomical points of reference for puncture site identification” Gawda et al (2016). Abstract: PURPOSE: We developed the new technique of the axillary vein catheterization, which is connected with the determination of only two anatomical points of […]
Using elastomeric devices for OPAT services administered by patients or caregivers
s-OPAT administered by patients or their caregivers using elastomeric devices was safe and effective in the treatment of infections in older people” Mujal et al (2016). Abstract: OBJECTIVES: We analyse the safety and effectiveness of self-outpatient parenteral antimicrobial therapy (s-OPAT) in older patients. [ctt tweet=”ReTweet if useful… Using elastomeric devices for OPAT services administered by […]
Selection and procurement of phlebotomy blood collection devices
The selection or procurement of blood collection devices in healthcare facilities is often an underestimated issue” Lippi et al (2016). Abstract: The selection or procurement of blood collection devices in healthcare facilities is often an underestimated issue. This is probably due to different factors including the lack of knowledge of policymakers, hospital administrators and even […]
Extended-infusion concentrations of vancomycin and piperacillin–tazobactam
The compatibility of vancomycin and piperacillin–tazobactam in concentrations typically used in extended-infusion dosing schemes was evaluated” O’Donnell et al (2016). Abstract: Purpose: The compatibility of vancomycin and piperacillin–tazobactam in concentrations typically used in extended-infusion dosing schemes was evaluated. [ctt tweet=”ReTweet if useful… Extended-infusion concentrations of vancomycin and piperacillin–tazobactam http://ctt.ec/Le4ch+ @ivteam #ivteam” coverup=”Le4ch”] Methods: Piperacillin–tazobactam was […]
Ultrasound gel contamination reviewed in this study
This investigation identified the use of contaminated gel as the common source causing an outbreak on a larger scale than had been recognised” Cheng et al (2016). Abstract: Background: Post-procedural infections by Mycobacterium abscessus complex are increasing worldwide and the source and route of transmission are infrequently identified. Here the extension of a previous clustering […]
Simon Flood and Andrew Bodenham review ultrasound guided central venous access
The UK National Institute for Health and Care Excellence (NICE) has recommended since 2002 that following appropriate training, clinicians should use ultrasound wherever practical in both elective and emergency internal jugular vein catheterization. Most clinicians would now recommend its use for all routes of access” Flood and Bodenham (2016). Abstract: Central venous cannulation is commonly […]
Prevention and management of neonatal procedural pain
Neonates at greatest risk of neurodevelopmental impairment as a result of preterm birth (ie, the smallest and sickest) are also those most likely to be exposed to the greatest number of painful stimuli in the NICU” AAP COMMITTEE (2016). Abstract: The prevention of pain in neonates should be the goal of all pediatricians and health […]
What is the frequency for central line dressing changes
To assess the effect of the frequency of CVAD dressing changes on the incidence of catheter-related infections and other outcomes including pain and skin damage” Gavin et al (2016). Abstract: BACKGROUND: People admitted to intensive care units and those with chronic health care problems often require long-term vascular access. Central venous access devices (CVADs) are […]
Do ethanol locks reduce CLABSI and mechanical central line problems
We sought to compare the rates of CRBSI, mechanical problems, and CVC-Rs in a cohort of pediatric patients with intestinal failure, with and without ELT (ELT+ and ELT-, respectively)” Mokha et al (2016). Abstract: OBJECTIVES: Although use of 70% ethanol lock therapy (ELT) has been shown to decrease the rate of catheter-related bloodstream infections (CRBSIs) […]
Measures to improve phlebotomy safety during patient identification and tube labelling
…the EFLM Working Group aims to encourage and support worldwide harmonisation of patient identification and tube labelling procedures in order to reduce the risk of preanalytical errors and improve patient safety” van Dongen-Lases et al (2016). Abstract: Venous blood sampling (phlebotomy) is the most common invasive procedure performed in patient care. Guidelines on the correct […]
Video-based assessment of peripheral intravenous catheter insertion
To describe the frequency of and factors associated with prolonged peripheral intravenous catheter (PIV) insertion in the resuscitation area of a pediatric emergency department (PED)” Vukovic et al (2016). Abstract: OBJECTIVE: To describe the frequency of and factors associated with prolonged peripheral intravenous catheter (PIV) insertion in the resuscitation area of a pediatric emergency department […]
Mixing intravenous medication and preventing glass particle contamination
This research aimed to study the difference in glass particle contamination from ampules with different intravenous administration methods commonly used in clinical practice” Joo et al (2016). Abstract: There have been many studies on glass particle contamination from glass ampules during the injection of glass ampules, but only the contamination from direct IV bolus injection […]
Vascular access team development improves infusion therapy care standards
The increased use of PICCs following the appointment of the vascular access team in 2008 led to an increase in PICC-associated bacteraemia” Shawyer (2016). Extract: The increased use of PICCs following the appointment of the vascular access team in 2008 led to an increase in PICC-associated bacteraemia. This was found to be the result not […]
Community intravenous therapy is both clinically and cost effective
This article discusses how the introduction of new ways of working has resulted in a more cost-effective service for the delivery of intravenous (IV) antibiotic therapy in a community setting” Baker and Lyden-Rodgers (20216). Abstract: This article discusses how the introduction of new ways of working has resulted in a more cost-effective service for the delivery […]
Trapezius placement of totally implantable vascular access devices
This article follows on from a previous discussion of the benefits of this approach, which illustrated and examined clinical outcomes of trapezius-placement versus anterior chest wall placed ports, for patients with metastatic subcutaneous disease on the anterior chest wall” Hill (2016). Abstract: Totally implantable vascular access devices (TIVADs) are indicated for intermittent long-term intravenous access. […]
Confirming PICC tip position without radiological assistance
No tip malpositions were reported and, as a result, the institution has been able to waive the requirement for confirmatory chest X-ray after PICC insertion, thus minimising the delay before the PICC can be used and increasing staff and patient confidence in the procedure” Barton (2016). Abstract: Peripherally inserted central catheters (PICCs) play a fundamental […]
Medical language use during peripheral intravenous catheter insertion
Medical language (e.g. transfusion, needle, blood, and chemo) can trigger emotions and memories; potentially jeopardising procedural outcomes for word-sensitised patients” Mackereth and Tomlinson (2016). Abstract: Cannulation can trigger anxieties in patients, and practitioners are often under pressure to achieve placement on the first attempt. Needles can deliver life-saving chemotherapies but can also be linked with side […]
Investing in vascular access and infusion therapy equipment
Senior managers must understand what they have invested in and how it enhances patient care, improves efficiency and saves money in order to be persuaded to continue to invest in and develop IV services” Oliver (2016). Extract: “Perhaps the key to starting or maintaining an IV service is through audit. What are we doing well? […]
How to teach totally implanted port vascular access device insertion
This article discusses the use of fresh frozen cadavers as an innovative way to teach the procedure of totally implanted port insertion” Kelly and Moss (2016). Abstract: This article discusses the use of fresh frozen cadavers as an innovative way to teach the procedure of totally implanted port insertion. In an attempt to increase the […]
Over-guidewire central venous catheter exchange in patients with CRBSI
This article gives us the unique opportunity to contribute to the ongoing discussion regarding the potential benefit of extending indications for these devices, including catheter-over-guidewire exchange in critically ill patients with CRBSI” La Greca et al (2016). Abstract: We read with great interest the article by Lorente et al dealing with the fascinating benefit of […]
Using power flush to correct misplaced central line tip
We tried old simple method of saline injection with force under image intensifier using hydrostatic force of intravenous fluid to straighten the CVC. We could successfully reposition two misplaced CVC’s using this method” Gautam et al (2015). Abstract: Malposition of central venous catheter is a well known technical complication. Misplaced catheter often requires reinsertion for […]