Nickel Barb
Barb Nickel is the critical care clinical nurse specialist for CHI Health St. Francis, a rural community hospital in Grand Island, Nebraska. She has served as chair/lead nurse planner for the Infusion Nurses Society's National Council on Education and is a member of the Infusion Nurses Society Standards Practice Committee
Crit Care Nurse. 2019 Feb;39(1):61-71. doi: 10.4037/ccn2019790.
The most common invasive procedure performed in the hospital setting worldwide is the insertion of a peripheral intravenous catheter. Although use of peripheral intravenous access is common, its presence is far from benign, with a reported 35% to 50% failure rate, even in facilities with a dedicated infusion team. Significant complications related to the presence of a peripheral intravenous site include localized infection, bacteremia, phlebitis, and infiltration or extravasation. Consistent application of evidence-based standards of practice in all aspects of peripheral intravenous catheter care is essential to provide infusion therapy that delivers safe and quality care. Management of peripheral intravenous access in the complex setting of critical care is examined in this article. A case study approach is used to illustrate application of infusion therapy standards of practice in peripheral intravenous catheter insertion, indications for catheter placement, and assessment parameters to enhance early recognition of peripheral intravenous access-related complications.
全球医院环境中最常见的侵入性操作是插入外周静脉导管。尽管外周静脉通路的使用很普遍,但其存在并非毫无问题,据报道,即使在配备专门输液团队的机构中,失败率也高达35%至50%。与外周静脉置管相关的重大并发症包括局部感染、菌血症、静脉炎以及渗漏或外渗。在所有外周静脉导管护理方面持续应用循证实践标准对于提供安全优质护理的输液治疗至关重要。本文探讨了重症监护复杂环境中外周静脉通路的管理。采用案例研究方法来说明输液治疗实践标准在外周静脉导管插入、导管放置指征以及评估参数中的应用,以加强对外周静脉通路相关并发症的早期识别。