Dramowski Angela, Erasmus Louisa, Fataar Aaqilah, Cotton Mark F, Whitelaw Andrew C, Coffin Susan, Bekker Adrie
Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Division of Medical Microbiology, Department of Pathology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service, Tygerberg Hospital, Cape Town, South Africa.
J Vasc Access. 2025 Jul;26(4):1355-1363. doi: 10.1177/11297298241278394. Epub 2024 Sep 19.
Short peripheral catheter (SPC)-associated complications occur frequently in hospitalised neonates. Few studies have reported the use of SPC care bundles in resource-limited neonatal units.
To evaluate the impact of a SPC care bundle on SPC associated complications (infiltration, dislodgement, phlebitis) and catheter dwell time.
We conducted a quasi-experimental study comparing neonatal SPC complications during a 2-month baseline and a 2-month intervention period, where a SPC care bundle was introduced including hand hygiene, insertion site antisepsis, nurse assistance during cannulation, IV insertion carts and IV securement dressings.
A total of 459 SPC days were observed in 223 neonates: 111 pre-intervention and 112 post-intervention (after SPC bundle implementation). Most neonates were preterm (208, 93.3%) with very or extremely low birth weight (133, 59.6%). SPC care bundle compliance was 43.8% for five bundle elements and 83.9% for four bundle elements. Most SPCs had unplanned removal within 48 h of insertion owing to infiltration or dislodgement (89/111 pre-intervention (80.2%) vs 90/112 post-intervention (80.4%); 0.974). No phlebitis was documented. The mean SPC dwell time was unchanged following bundle implementation (32.9 vs 34.2 h; = 0.376).
Infiltration and dislodgement occurred frequently necessitating replacement of four of every five SPCs. Despite moderate compliance with the SPC care bundle, the high rates of unplanned SPC removal and short duration of catheter dwell time were unchanged.Contribution:The SPC care bundle did not improve catheter dwell time; further research is needed to identify strategies to reduce unplanned SPC removal and extend catheter dwell time in hospitalised neonates.
住院新生儿中，外周短导管（SPC）相关并发症频繁发生。很少有研究报道在资源有限的新生儿病房中使用SPC护理集束。
评估SPC护理集束对SPC相关并发症（渗漏、移位、静脉炎）及导管留置时间的影响。
我们进行了一项准实验研究，比较2个月基线期和2个月干预期内新生儿SPC并发症情况，干预期引入了SPC护理集束，包括手卫生、穿刺部位消毒、置管时护士协助、静脉输液推车及静脉固定敷料。
共观察223例新生儿的459个SPC日：干预前111个，干预后（实施SPC护理集束后）112个。大多数新生儿为早产儿（208例，93.3%），极低或超低出生体重儿（133例，59.6%）。SPC护理集束五项内容的依从率为43.8%，四项内容的依从率为83.9%。大多数SPC在插入后48小时内因渗漏或移位而意外拔除（干预前89/111例（80.2%） vs 干预后90/112例（80.4%）；P = 0.974）。未记录到静脉炎。实施护理集束后SPC平均留置时间无变化（32.9小时 vs 34.2小时；P = 0.376）。
渗漏和移位频繁发生，每五个SPC中就有四个需要更换。尽管对SPC护理集束的依从性一般，但计划外SPC拔除率高和导管留置时间短的情况并未改变。贡献：SPC护理集束未改善导管留置时间；需要进一步研究以确定减少住院新生儿计划外SPC拔除及延长导管留置时间的策略。
