Tomobi Oluwakemi, Avoian Samantha, Ekwere Ifeoma, Waghmare Shivani, Diaban Fatima, Davis Gabrielle, Sy Yacine, Ogbonna Oluchi, Streete Kevin, Aryee Ebenezer, Kulasingham Vasanthini, Sampson John B
Department of Anesthesiology, West Virginia University, Morgantown, WV, United States.
Division of Health, Science, and Technology, Howard Community College, Columbia, MD, United States.
Front Med (Lausanne). 2024 Feb 20;11:1326144. doi: 10.3389/fmed.2024.1326144. eCollection 2024.
Intravenous (IV) therapy is a crucial aspect of care for the critically ill patient. Barriers to IV infusion pumps in low-resource settings include high costs, lack of access to electricity, and insufficient technical support. Inaccuracy of traditional drop-counting practices places patients at risk. By conducting a comparative assessment of IV infusion methods, we analyzed the efficacy of different devices and identified one that most effectively bridges the gap between accuracy, cost, and electricity reliance in low-resource environments.
In this prospective mixed methods study, nurses, residents, and medical students used drop counting, a manual flow regulator, an infusion pump, a DripAssist, and a DripAssist with manual flow regulator to collect normal saline at goal rates of 240, 120, and 60 mL/h. Participants' station setup time was recorded, and the amount of fluid collected in 10 min was recorded (in milliliters). Participants then filled out a post-trial survey to rate each method (on a scale of 1 to 5) in terms of understandability, time consumption, and operability. Cost-effectiveness for use in low-resource settings was also evaluated.
The manual flow regulator had the fastest setup time, was the most cost effective, and was rated as the least time consuming to use and the easiest to understand and operate. In contrast, the combination of the DripAssist and manual flow regulator was the most time consuming to use and the hardest to understand and operate.
The manual flow regulator alone was the least time consuming and easiest to operate. The DripAssist/Manual flow regulator combination increases accuracy, but this combination was the most difficult to operate. In addition, the manual flow regulator was the most cost-effective. Healthcare providers can adapt these devices to their practice environments and improve the safety of rate-sensitive IV medications without significant strain on electricity, time, or personnel resources.
静脉输液治疗是重症患者护理的关键环节。资源匮乏地区静脉输液泵存在的障碍包括成本高昂、无法获得电力以及技术支持不足。传统滴数计数方法的不准确使患者面临风险。通过对静脉输液方法进行比较评估,我们分析了不同设备的功效,并确定了一种在资源匮乏环境中最能有效弥合准确性、成本和电力依赖之间差距的设备。
在这项前瞻性混合方法研究中,护士、住院医师和医学生使用滴数计数法、手动流量调节器、输液泵、滴数辅助器以及带有手动流量调节器的滴数辅助器,以240、120和60毫升/小时的目标速率收集生理盐水。记录参与者的设备设置时间,并记录10分钟内收集的液体量(以毫升为单位)。然后,参与者填写一份试验后调查问卷,以1至5分的量表对每种方法在可理解性、耗时性和可操作性方面进行评分。还评估了在资源匮乏地区使用的成本效益。
手动流量调节器的设置时间最快,成本效益最高,并且在使用中耗时最少、最易于理解和操作。相比之下,滴数辅助器和手动流量调节器的组合使用起来耗时最长,最难理解和操作。
单独使用手动流量调节器耗时最少且最易于操作。滴数辅助器/手动流量调节器组合提高了准确性,但这种组合最难操作。此外,手动流量调节器成本效益最高。医疗保健提供者可以根据其实践环境调整这些设备,并提高对速率敏感的静脉用药的安全性,而不会对电力、时间或人力资源造成重大压力。