Infection Control, Methodist Hospitals, Gary, IN, USA; Alliance for Vascular Access Teaching and Research, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.
Vascular Access Team, Methodist Hospitals, Gary, IN, USA.
Am J Infect Control. 2019 Sep;47(9):1118-1121. doi: 10.1016/j.ajic.2019.03.001. Epub 2019 Apr 30.
To reduce excess central line use and provide an option for difficult venous access patients through the introduction of a midline catheter.
Design included prospective monitoring of the implementation of a quality improvement project. The setting was a 576 bed, urban, community, nonprofit, Magnet recognized, level 3 trauma center serving primarily adult patients. Midline and peripherally inserted central catheters were inserted by a specialty nursing team; care and maintenance of all devices were provided by front line staff.
Zero midline catheter infections were observed in the 24 months after implementation of the fixed length, power injectable device. Completion of therapy was 80%, the most frequently encountered complication was device dislodgement.
Adoption of a vascular access nurse led midline catheter program, coupled with device selection algorithms expanded the ability to select the right device for the patient, while decreasing excess central line usage without additional increased risks to the patient.
通过引入中线导管,减少过度使用中心静脉导管,并为静脉穿刺困难的患者提供一种选择。
设计包括前瞻性监测质量改进项目的实施。该研究地点是一家拥有 576 张床位的城市、社区、非营利性、获得磁铁认证的、三级创伤中心,主要为成年患者服务。中线和外周插入的中央导管由专业护理团队插入;一线工作人员提供所有设备的护理和维护。
在实施固定长度、可进行动力注射的设备后的 24 个月中,未观察到中线导管感染。治疗完成率为 80%,最常见的并发症是器械移位。
采用血管通路护士主导的中线导管项目,并结合器械选择算法,扩大了为患者选择合适器械的能力,同时减少了中心静脉导管的过度使用,而不会给患者带来额外的风险增加。