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双腔注射器与传统注射器用于外周静脉药物给药和导管冲洗的比较:一项随机对照试验研究方案。

Double-chamber syringe versus classic syringes for peripheral intravenous drug administration and catheter flushing: a study protocol for a randomised controlled trial.

机构信息

Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra (ESEnfC), Avenida Bissaya Barreto, Apartado 7001, 3046-851, Coimbra, Portugal.

Biophysics Institute, Coimbra Institute for Clinical and Biomedical Research (iCBR) area of CIMAGO, Faculty of Medicine, CNC.IBILI, Faculty of Medicine, University of Coimbra, Polo das Ciências da Saúde Azinhaga de Santa Comba, 3000-354, Coimbra, Portugal.

出版信息

Trials. 2020 Jan 14;21(1):78. doi: 10.1186/s13063-019-3887-1.

Abstract

BACKGROUND

The prevention of catheter-related complications is nowadays an important topic of research. Flushing catheters is considered an important clinical procedure in preventing malfunction and several complications such as phlebitis or infection. Considering the latest guidelines of the Infusion Nurses Society, the flushing should be carried out both pre- and post-drug administration, requiring different syringes (with associated overall increased times of preparation/administration of intravenous medication by nurses, and also increasing the need for manipulation of the venous catheter).

METHODS/DESIGN: A multi-centre, two-arm randomised controlled trial with partially blinded outcome assessment of 146 adult patients. After eligibility analysis and informed consent, participants will receive usual intravenous administration drugs with flushing procedures, with a double-chamber syringe (arm A) or with classic syringes (arm B). The outcomes assessment will be performed on a daily basis by an unblinded ward team, with the same procedures in both groups. Some main outcomes, such as phlebitis and infiltration, will also be evaluated by nurses from a blinded research team and registered once a day.

DISCUSSION

The study outlined in this protocol will provide valuable insight regarding the effectiveness and safety of this new medical device. The development of this medical device (dual-chamber syringe, for drug and flush solution) seems to be an important step to facilitate nurses' adoption of good clinical practices in intravenous procedures, reducing catheter manipulations.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT04046770. Registered 13 August 2019.

摘要

背景

预防导管相关并发症是当今研究的重要课题。冲洗导管被认为是预防故障和几种并发症(如静脉炎或感染)的重要临床操作。考虑到输液护士协会的最新指南,冲洗应在给药前后进行,需要使用不同的注射器(这会增加护士准备/给药的总时间,也会增加对静脉导管的操作需求)。

方法/设计:一项多中心、双臂、随机对照试验,对 146 名成年患者进行部分盲法结局评估。经过资格分析和知情同意后,参与者将接受常规静脉内药物治疗,并进行冲洗程序,使用双腔注射器(A 组)或经典注射器(B 组)。每天由非盲病房团队进行结局评估,两组均采用相同的程序。一些主要结局,如静脉炎和渗漏,也将由盲法研究团队的护士进行评估,并每天登记一次。

讨论

本方案中概述的研究将为这种新医疗器械的有效性和安全性提供有价值的见解。这种医疗器械(双腔注射器,用于药物和冲洗液)的开发似乎是促进护士在静脉内操作中采用良好临床实践的重要步骤,可以减少导管操作。

试验注册

ClinicalTrials.gov,NCT04046770。2019 年 8 月 13 日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4323/6961373/d9b912e97990/13063_2019_3887_Fig1_HTML.jpg

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