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葡萄牙外周静脉置管集束方案的循证制定:一项德尔菲共识研究

Evidence-Informed Development of a Bundle for Peripheral Intravenous Catheterization in Portugal: A Delphi Consensus Study.

作者信息

Santos-Costa Paulo, Paiva-Santos Filipe, Sousa Liliana B, Bernardes Rafael A, Ventura Filipa, Salgueiro-Oliveira Anabela, Parreira Pedro, Vieira Margarida, Graveto João

机构信息

The Health Sciences Research Unit: Nursing, Nursing School of Coimbra, 3004-011 Coimbra, Portugal.

Instituto Ciências da Saúde, Universidade Católica Portuguesa, 4169-005 Porto, Portugal.

出版信息

Nurs Rep. 2022 Jul 7;12(3):498-509. doi: 10.3390/nursrep12030047.

Abstract

UNLABELLED

Contrary to many international settings, there are no clinical guidelines for peripheral intravenous catheter (PIVC) insertion and maintenance in Portugal. We sought to derive an international consensus on a PIVC bundle that could guide Portuguese nurses' clinical decision-making in this scope.

METHODS

Two international vascular access specialist groups participated in an online Delphi panel. During the first round, specialists ( = 7) were sent a summary report from a previous observational study conducted in a surgical ward in Portugal. Based on the report findings, specialists were asked to provide five to eight PIVC insertion and maintenance interventions. Then, another set of specialists ( = 7) scored and revised the recommendations until a consensus was reached (≥70% agreement). The PIVC bundle was made available and discussed with the surgical ward's nurses.

RESULTS

After three rounds, a consensus was achieved for five evidence-informed interventions: (i) involve the person and assess the peripheral venous network; (ii) maintain an aseptic no-touch technique; (iii) ensure proper catheter dressing and fixation; (iv) perform catheter flush & lock; (v) test the peripheral venous catheter's functionality and performance at each shift.

CONCLUSION

The final version of the PIVC bundle achieved consensus among international experts. Despite the positive feedback provided by the ward nurses, future studies are warranted to assess its effectiveness in standardizing PIVC care delivery and its potential implications for care outcomes in Portuguese clinical settings.

摘要

未标注

与许多国际情况不同,葡萄牙没有关于外周静脉导管(PIVC)插入和维护的临床指南。我们试图就一套PIVC综合措施达成国际共识,以指导葡萄牙护士在这方面的临床决策。

方法

两个国际血管通路专家小组参与了在线德尔菲小组。在第一轮中,向专家(n = 7)发送了之前在葡萄牙一个外科病房进行的观察性研究的总结报告。根据报告结果,要求专家提供五到八项PIVC插入和维护干预措施。然后,另一组专家(n = 7)对这些建议进行评分并修订,直到达成共识(≥70%的一致意见)。该PIVC综合措施提供给外科病房的护士并进行了讨论。

结果

经过三轮,就五项基于证据的干预措施达成了共识:(i)让患者参与并评估外周静脉网络;(ii)保持无菌无接触技术;(iii)确保正确的导管敷料和固定;(iv)进行导管冲洗和封管;(v)每班测试外周静脉导管的功能和性能。

结论

PIVC综合措施的最终版本在国际专家中达成了共识。尽管病房护士提供了积极反馈,但仍有必要进行未来研究,以评估其在规范PIVC护理提供方面的有效性及其对葡萄牙临床环境中护理结果的潜在影响。

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