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外周静脉置管的流行情况和使用模式:私立医院环境中的现况调查。

The prevalence of peripheral intravenous cannulae and pattern of use: A point prevalence in a private hospital setting.

机构信息

Clinical Governance Unit, Cabrini Health, Malvern, Vic., Australia.

St John of God Subiaco Hospital, Subiaco, WA, Australia.

出版信息

J Clin Nurs. 2018 Jan;27(1-2):e363-e367. doi: 10.1111/jocn.13961. Epub 2017 Dec 6.

Abstract

AIMS AND OBJECTIVES

To determine the prevalence and pattern of use of peripheral intravenous cannulae in hospital wards.

BACKGROUND

Peripheral intravenous cannulae are commonly used in acute health care to directly access the bloodstream for the administration of medications, intravenous fluids and blood products. Peripheral intravenous cannulae are associated with multiple adverse events including hospital-acquired bloodstream infection, thrombophlebitis and pain/discomfort. Administration of intravenous fluids is associated with impaired mobility and nocturia which may increase falls risk in the older people.

DESIGN

Observational, point prevalence study.

METHODS

Three private hospitals comprising a total of 1,230 beds participated in the study. Nurses recorded the presence of a peripheral intravenous cannulae, duration of insertion, state of the dressing and whether the peripheral intravenous cannulae was accessed in the previous 24 hr and for what purpose. Nurses were also asked whether they would replace the peripheral intravenous cannulae should it fail.

RESULTS

Approximately one-quarter of patients had a peripheral intravenous cannulae, the majority of which had been present for <24 hr. The major use of the peripheral intravenous cannulae was antibiotic administration. Administration of intravenous fluids occurred in the presence of normal oral fluid intake. Nurses would not replace one-third of peripheral intravenous cannulae in the event of failure. A majority of patients were at increased falls risk, and one-third of these were receiving intravenous fluids.

CONCLUSIONS

There is room for improvement in the utilisation of peripheral intravenous cannulae, particularly in removal and associated use of intravenous fluids. Alternative strategies for medication administration and timely switch to the oral route may reduce the risks associated with intravenous fluids.

RELEVANCE TO CLINICAL PRACTICE

Vigilance is required in the use of peripheral intravenous cannulae. Consider transition of medication administration to oral intake where possible to minimise risks associated with the use of invasive devices and increased fluid intake.

摘要

目的和目标

确定医院病房外周静脉置管的使用情况和流行率。

背景

外周静脉置管在急性医疗保健中常用于直接进入血液系统,以给药、静脉输液和血液制品。外周静脉置管与多种不良事件有关,包括医院获得性血流感染、血栓性静脉炎和疼痛/不适。静脉输液的给予与活动受限和夜间多尿有关,这可能会增加老年人跌倒的风险。

设计

观察性、时点患病率研究。

方法

三家私营医院共有 1230 张床位参与了这项研究。护士记录外周静脉置管的存在、插入时间、敷料状态以及在前 24 小时内是否使用过外周静脉置管以及用于何种目的。护士还被问到如果外周静脉置管失败,他们是否会更换。

结果

约四分之一的患者有外周静脉置管,其中大多数存在时间不到 24 小时。外周静脉置管的主要用途是给予抗生素。在正常口服液体摄入的情况下给予静脉输液。如果外周静脉置管失败,护士将不会更换三分之一的外周静脉置管。大多数患者有增加的跌倒风险,其中三分之一正在接受静脉输液。

结论

在外周静脉置管的使用方面仍有改进的空间,特别是在去除和相关使用静脉输液方面。替代药物管理策略和及时转为口服途径可能会降低与静脉输液相关的风险。

临床意义

在外周静脉置管的使用中需要保持警惕。在可能的情况下,考虑将药物管理转换为口服摄入,以尽量减少与使用侵入性装置和增加液体摄入相关的风险。

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