Daily Dressing Change Effects on Skin Flora Beneath Subclavian Catheter Dressings During Total Parenteral Nutrition

Jarrard, Marilyn M.; Olson, Charles M.; Freeman, Joel B.

doi:10.1177/014860718000400411

Cited by 16 publications

(4 citation statements)

References 2 publications

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“…Prompt diagnosis and management of infection and removal of catheters infected with organisms deemed to be difficult to treat by antimicrobial administration alone, such as in fungal infections, may also reduce complications associated with central venous catheter usage. [24][25][26][27][28] Furthermore, our group showed a significant association between higher mean blood glucose levels during hospitalization and increased risk for posthospital BSI in adults on HPN (unpublished study). The purpose of this study was to assess the incidence, manifestations, and etiology of CA-BSI in children receiving HPN in a major metropolitan area of the southeastern United States.…”

Section: Introductionmentioning

confidence: 75%

Characterization of Posthospital Bloodstream Infections in Children Requiring Home Parenteral Nutrition

Mohammed

Zhao

Shane

et al. 2011

J Parenter Enteral Nutr

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Background: Home parenteral nutrition (HPN) is lifesaving for children with intestinal failure. Catheter‐associated bloodstream infections (CA‐BSI) are common in hospitalized patients receiving parenteral nutrition (PN), but data evaluating CA‐BSI in children receiving HPN are limited. Objective: To determine the incidence and characteristics of CA‐BSI in children receiving HPN. Methods: Medical records of 44 children receiving HPN during a 3‐year period were reviewed. End points were CA‐BSI during the initial 6 months after discharge. CA‐BSI was defined as isolation of pathogens from blood requiring antimicrobial therapy. Results: The primary indication for HPN was short bowel syndrome (46%), and 59 BSI were documented during the initial 6 months of HPN in 29 (66%) children. Of CA‐BSI, polymicrobial infections accounted for 52%; gram‐positive, 29%; gram‐negative, 17%; and fungal, 2%. CA‐BSI incidence per 1000 catheter‐days was highest during the first month posthospital discharge (72 episodes; 95% confidence interval [CI], 45.4–109.6). CA‐BSI incidence density ratio for children receiving HPN for >90 days compared with those receiving HPN for <30 days was 2.2 (P < .05). Logistic regression revealed that Medicaid insurance and age <1 year were associated with increased risk for CA‐BSI (odds ratio [OR], 4.4 [95% CI, 1.13–16.99] and 6.6 [1.50–28.49], respectively; P < .05). Conclusions: The incidence of CA‐BSI in children receiving HPN is highest during the first month posthospital discharge. Strategies to address care in the immediate posthospital discharge period may reduce the burden of infectious complications of HPN.

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Section: Introductionmentioning

confidence: 75%

Characterization of Posthospital Bloodstream Infections in Children Requiring Home Parenteral Nutrition

Mohammed

Zhao

Shane

et al. 2011

J Parenter Enteral Nutr

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“…Prominence has been given in the literatureto the hypothesis that infecting organisms in catheter related sepsis come from the skin around the site of entry. Some studies have shown a correlation between positive skin cultures and development of line sepsis ( I I) but others have not demonstrated such a link (4). If our types of dressing were somehow altering skin colonisation around the catheter insertion area, one would have first to be convinced that this was of prime importance in the aetiology of line sepsis to then accept it as an explanation for the marked difference in sepsis rate we observed.…”

Section: Discussionmentioning

confidence: 81%

Percutaneous Central Venous Feeding Lines in Infants: Do They Perform as Well as Surgically Positioned Catheters?

Puntis

Ball²,

Booth³

1987

Eur J Pediatr Surg

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The complications of the administration of parenteral nutrition by central venous catheter were reviewed retrospectively in 71 neonates and infants under the age of nine months. The performance of central catheters inserted by a standard surgical method was compared with that of central catheters introduced by a percutaneous insertion technique using peripheral veins and carried out on the ward. The incidence of catheter related sepsis in percutaneously inserted lines was significantly less (p less than 0.05) than in surgically inserted lines, but in all other respects, there were no significant differences in performance. These findings demonstrate that percutaneous insertion is a simple, safe and cost-effective alternative to surgical placement of feeding catheters in neonates and infants.

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“…The authors noted, however, that daily changes were costly in terms of labor and supplies and might best be reserved for patients at high risk for sepsis. In contrast to the findings of Jarrard et al (1980), other investigators have observed little relationship between skin flora and catheter sepsis (e.g., Sitges-Serra et al, 1984). These disparate fmdings require further investigation.…”

Section: Enteral Feedingmentioning

confidence: 71%

Nutrition‐related Nursing Research

Moore

Guenter²,

Bender

1986

Image: the Journal of Nursing Scholarship

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o identify the contribution of nurses to the nutrition research literature between 1970 and 1984, nursing and multidisciplinary research journals T were reviewed. A total of 104 nutrition research articles with nurses as first author or co-author were identified. More than two thirds of the articles have been published since 1980; only nine had been published prior to 1977. Of the articles, 55 were primarily nursing research and 49 were the result of team research. More than half (28) of the 55 articles were found in two journals, Nursing Research and The Journal of Parentera1 and Enieral Nutrition (JPEN). Most of the articles that were the result of team research were published in JPEN. *Nurses involved primarily in nursing research had higher educational levels overall than did those involved in team research. Of the 101 nurses involved in nursing research, 79 % had education preparation beyond the bachelor's degree; of the nurses who served as first authors, 76% were educated beyond the bachelor's level. Of the 57 nurses involved in team research, 20 % had postbaccalaureate education, and one had a doctoral degree.Even in the nursing research studies there was an emphasis on collaboration, with 36 of the 55 nursing studies involved in collaboration with one or more nurses, physicians, dietitians, or other professionals.The topics of the studies are shown in Table 1. As can be seen, more articles were related to nutrition support than to any other topic. (Nutrition support may be defined as "the provision of specially formulated andor delivered intravenous or enteral nutrients to prevent or treat malnutrition.") (Committee on Standards, 1985). It was found that 19 (34%) of the nursing studies and 10 (20%) of the team studies dealt with delivery and tolerance of enteral feedings; 11 % of the nursing studies and 43% of the team studies were concerned with the patient's receiving total parented *A copy of the bibliography of nursing research articles idmth5cd is available from the authors. nutrition; and four (7%) of the nursing studies and 15 (31 %) of the team studies investigated nutrition assessment methods (see Table 1).Of the nursing studies 38 were nonexperimental, nine were quasi-experimental or preaxperimental, and eight were experimental. The sample size among the studies ranged from two to 165.

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Daily Dressing Change Effects on Skin Flora Beneath Subclavian Catheter Dressings During Total Parenteral Nutrition

Cited by 16 publications

References 2 publications

Characterization of Posthospital Bloodstream Infections in Children Requiring Home Parenteral Nutrition

Characterization of Posthospital Bloodstream Infections in Children Requiring Home Parenteral Nutrition

Percutaneous Central Venous Feeding Lines in Infants: Do They Perform as Well as Surgically Positioned Catheters?

Nutrition‐related Nursing Research

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