McParlan Dympna, Edgar L, Gault M, Gillespie S, Menelly R, Reid M
Infusional Services Team, Cancer Centre, Belfast City Hospital, Belfast, UK.
J Vasc Access. 2020 Jan;21(1):33-38. doi: 10.1177/1129729819851059. Epub 2019 Jun 4.
The Infusional Services Team at a large cancer centre in Belfast, Northern Ireland, performed a cross-sectional analysis of two catheter securement technologies to address an area of frequent, but underestimated concern - peripherally inserted central catheter migration and dislodgement. Healthcare practitioner and patient feedback, along with economic impact, were assessed. The costs associated with catheter replacement during the adhesive device group study period were calculated using an average cost per insertion, based on material costs required for the procedure. Other factors were the replacement cost of the adhesive engineered securement device with each dressing change. In the subcutaneous securement group, the material costs were adjusted for use of the subcutaneous device as it remained in situ for the duration of the catheters' dwell time. This review found that subcutaneous securement offers both patient and facilities a safe, effective and economical alternative for device securement with patients who are unable to tolerate or have successful securement with adhesive securement devices. The use of subcutaneous devices provided for reduced risks for peripherally inserted central catheters in terms of dislodgement, migration or malposition, alleviating the potential risks to develop catheter-related thrombosis and device-related infection.
北爱尔兰贝尔法斯特一家大型癌症中心的输液服务团队，对两种导管固定技术进行了横断面分析，以解决一个经常被忽视但备受关注的领域——外周静脉穿刺中心静脉导管的移位和脱出问题。评估了医疗从业者和患者的反馈以及经济影响。在粘性装置组研究期间，根据每次插入所需的材料成本计算平均每次插入成本，以此来计算与导管更换相关的成本。其他因素包括每次更换敷料时粘性工程固定装置的更换成本。在皮下固定组中，由于皮下装置在导管留置期间一直留在原位，因此对其材料成本进行了调整。该综述发现，对于无法耐受粘性固定装置或使用粘性固定装置固定不成功的患者，皮下固定为患者和医疗机构提供了一种安全、有效且经济的固定替代方案。使用皮下装置可降低外周静脉穿刺中心静脉导管发生移位、迁移或位置不当的风险，减轻发生导管相关血栓形成和装置相关感染的潜在风险。
