epic3: revised recommendation for intravenous catheter and catheter site care

Loveday, Heather; Wilson, Jennie; Prieto, J.; Wilcox, Mark H.

doi:10.1016/j.jhin.2015.11.011

Cited by 18 publications

(14 citation statements)

References 14 publications

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“…However, these small catheter movements occurred both inwards and outwards relative to the skin, which may facilitate the introduction of micro-organisms located at this site. This is consistent with the recognized risk of CRI originating from micro-organisms at the CVC insertion site [10] and the recommended use of chlorhexidine dressings to decrease this microbial load [3, 11]. CVC migration was most likely related to the relative movements of the patient and the overall weight of the external components of the CVC, as was observed with 4- compared with 3-lumen CVC secured with sutures.…”

Section: Discussionsupporting

confidence: 76%

A clinical evaluation of two central venous catheter stabilization systems

Kärpänen

Casey

Whitehouse

et al. 2019

Ann. Intensive Care

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Background Central venous catheters (CVCs) are commonly secured with sutures which are associated with microbial colonization and infection. We report a comparison of a suture-free system with standard sutures for securing short-term CVC in an international multicentre, prospective, randomized, non-blinded, observational feasibility study. Consented critical care patients who had a CVC inserted as part of their clinical management were randomized to receive either sutures or the suture-free system to secure their CVC. The main outcome measures were CVC migration (daily measurement of catheter movement) and unplanned catheter removals. Results The per cent of unplanned CVC removal in the two study groups was 2% (suture group 2 out of 86 patients) and 6% (suture-free group 5 out of 85 patients). Both securement methods were well tolerated in terms of skin irritation. The time and ease of application and removal of either securement systems were not rated significantly different. There was also no significant difference in CVC migration between the two securement systems in exploratory univariate and multivariate analyses. Overall, 42% (36 out of 86) of the CVC secured with sutures and 56% (48 out of 85) of the CVC secured with the suture-free securement system had CVC migration of ≥ 2 mm. Conclusions The two securement systems performed similarly in terms of CVC migration and unplanned removal of CVC; however, the feasibility study was not powered to detect statistically significant differences in these two parameters. Trial registration ISRCTN, ISRCTN13939744. Registered 9 July 2015, http://www.isrctn.com/ISRCTN13939744 .

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Section: Discussionsupporting

confidence: 76%

A clinical evaluation of two central venous catheter stabilization systems

Kärpänen

Casey

Whitehouse

et al. 2019

Ann. Intensive Care

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“…The findings related to dressing status, visual inspection, and unnecessary PIVCs were moderate. International evidence recommends that PIVC dressings should be intact, clean, and dry, plus adequately secured and visible during the inspection of insertion site for prevention of PIVC failure [ 29 – 31 ]. The 34% of transparent dressings were not in optimal conditions, a rate comparable to the 21–34% of dressings compromised (moist, soiled, inadequately secured, or lifting of the skin) reported previously [ 1 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

Care of peripheral intravenous catheters in three hospitals in Spain: Mapping clinical outcomes and implementation of clinical practice guidelines

et al. 2020

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Background Peripheral intravenous catheters (PIVCs) are the most widely used invasive devices worldwide. Up to 42% of PIVCs are prematurely removed during intravenous therapy due to failure. To date, there have been few systematic attempts in European hospitals to measure adherence to recommendations to mitigate PIVC failures. Aim To analyse the clinical outcomes from clinical practice guideline recommendations for PIVC care on different hospital types and environments. Methods We conducted an observational study in three hospitals in Spain from December 2017 to April 2018. The adherence to recommendations was monitored via visual inspection in situ evaluations of all PIVCs inserted in adults admitted. Context and clinical characteristics were collected by an evaluation tool, analysing data descriptively. Results 646 PIVCs inserted in 624 patients were monitored, which only 52.7% knew about their PIVC. Regarding PIVC insertion, 3.4% (22/646) patients had at least 2 PIVCs simultaneously. The majority of PIVCs were 20G (319/646; 49.4%) and were secured with transparent polyurethane dressing (605/646; 93.7%). Most PIVCs (357/646; 55.3%) had a free insertion site during the visual inspection at first sight. We identified 342/646 (53%) transparent dressings in optimal conditions (clean, dry, and intact dressing). PIVC dressings in medical wards were much more likely to be in intact conditions than those in surgical wards (234/

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“…The IV catheter care bundle includes a best practice checklist for catheter insertion, appropriate post-insertion catheter care, and prompt removal of the catheter when no longer required for patient care [113][114][115]. Nursing staff have an important role during these processes, but any personnel involved with the care of intravascular catheters should be trained and competent.…”

Section: Role Of Nursing Carementioning

confidence: 99%

A state of the art review on optimal practices to prevent, recognize, and manage complications associated with intravascular devices in the critically ill

et al. 2018

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Intravascular catheters are inserted into almost all critically ill patients. This review provides up-to-date insight into available knowledge on epidemiology and diagnosis of complications of central vein and arterial catheters in ICU. It discusses the optimal therapy of catheter-related infections and thrombosis. Prevention of complications is a multidisciplinary task that combines both improvement of the process of care and introduction of new technologies. We emphasize the main component of the prevention strategies that should be used in critical care and propose areas of future investigation in this field.

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epic3: revised recommendation for intravenous catheter and catheter site care

Cited by 18 publications

References 14 publications

A clinical evaluation of two central venous catheter stabilization systems

A clinical evaluation of two central venous catheter stabilization systems

Care of peripheral intravenous catheters in three hospitals in Spain: Mapping clinical outcomes and implementation of clinical practice guidelines

A state of the art review on optimal practices to prevent, recognize, and manage complications associated with intravascular devices in the critically ill

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