Chief Clinical Officer, SkyDance Vascular, Inc, Louisville, KY.
Department of Physiology and Biophysics, University of Louisville, KY.
Br J Nurs. 2023 Jul 27;32(14):S30-S34. doi: 10.12968/bjon.2023.32.14.S30.
Over-the-needle (OTN) PIVC devices are at inherent risk of insertion related skin contamination. Through-the-needle (TTN) catheter deployment resulted in no measurable contamination in this study. OTN catheters were 1.67 times more likely to be contaminated than TTN in this study.
To compare a traditional over-the-needle peripheral intravenous catheter device to a through-the-needle (TTN) peripheral intravenous catheter device for early bacterial contamination during insertion.
Five TTN test devices (OspreyIV 20 g SkyDance Vascular, Inc) and 5 OTN comparative devices (Insyte Autoguard 20 g Becton Dickinson) were aseptically inserted through targeted zones inoculated with 1 mL aliquot suspension of approximately 1 × 10 CFU of among 3 healthy sheep. Immediately after insertion, each study catheter was surgically removed from the surrounding tissue and cultured for the presence of inoculum that may have been transferred to the catheter during insertion.
Final culture results of the 5 test articles found no bacterial colonies. Final culture results of the 5 comparative articles revealed 2 of 5 were contaminated with bacterial colonies. The absolute risk reduction is 40%, or a 40% rate of contamination drops to a 0% rate of contamination when the TTN catheter deployment was used. The risk ratio achieved was 1.67, indicating catheters placed using the OTN deployment were 1.67 times more like to be contaminated than the TTN deployed catheters.
In this present ovine study, the data revealed that use of a novel TTN approach resulted in less contamination than the more traditional OTN approach. Traditional OTN devices, developed over 70 years ago, are at inherent risk of insertion-related contact contamination. The results of this research, as well as previously published studies, point toward considering physical catheter protection strategies such as TTN devices as a potential alternative to OTN devices.
经皮穿刺（OTN）外周静脉置管器在插入时存在固有皮肤污染的风险。在本研究中，经皮穿刺（TTN）导管的部署没有导致可测量的污染。在本研究中，OTN 导管的污染可能性比 TTN 导管高 1.67 倍。
比较传统的经皮穿刺外周静脉置管器与经皮穿刺（TTN）外周静脉置管器在插入过程中早期细菌污染的情况。
将 5 个 TTN 测试装置（OspreyIV 20g SkyDance Vascular，Inc）和 5 个 OTN 比较装置（Insyte Autoguard 20g Becton Dickinson）无菌插入到经过靶向区域接种了 1 毫升约 1×10 CFU 的悬浮液的 3 只健康绵羊中。插入后，立即将每个研究导管从周围组织中取出，并培养是否存在接种物转移到导管中。
5 个测试物品的最终培养结果均未发现细菌菌落。5 个对照物品的最终培养结果显示，有 2 个被细菌菌落污染。绝对风险降低 40%，即当使用 TTN 导管部署时，污染率从 40%下降到 0%。风险比达到 1.67，这表明使用 OTN 部署放置的导管比使用 TTN 部署放置的导管更有可能被污染。
在本羊研究中，数据显示使用新型 TTN 方法比传统的 OTN 方法导致的污染更少。70 多年前开发的传统 OTN 装置存在插入相关接触污染的固有风险。这项研究的结果以及以前发表的研究表明，考虑使用物理导管保护策略，如 TTN 装置，作为 OTN 装置的潜在替代方案。
