Impacto de la implantación de recordatorios para disminuir eventos adversos en pacientes con accesos venosos periféricos

Abstract

Fundamento. Medir el impacto clínico de la implantación de un sistema de recordatorios, que avise de los pacientes que tienen riesgo de presentar un evento adverso (EA) relacionado con los catéteres venosos periféricos. Métodos.A partir de los registros que se utilizan para seguimiento de los catéteres intravenosos se desarrolló una consulta automatizada que elabora un listado de los pacientes ingresados que incluye fecha de ingreso, fecha colocación, vía y tipo de vía. Se actualiza por turno en los ordenadores de la unidad. Se implantó en enero de 2010. Se ha realizado un estudio cuasiexperimental midiendo la incidencia acumulada de flebitis, extravasaciones y obstrucciones en los pacientes dados de alta en 2009 y en 2010. Se ha evaluado la asociación entre variables cualitativas con el test de Chi cuadrado, se ha estimado riesgo relativo (RR) y el número necesario de pacientes a tratar (NNT). conclusiones. Un listado de recordatorios que incluye los pacientes con acceso vascular y la fecha de éste, ha servido para disminuir el número de flebitis y extravasaciones, pero no las obstrucciones.Palabras clave. Sistemas recordatorios. Sistemas de registros médicos computarizados. Cateterización venosa perifé-rica. Eventos adversos. Hospitalización. abstract background. The main purpose of this paper is to measure the clinical impact of the implementation of a reminder system that would warn of patients who are at risk of presenting an adverse event (AE) related to the peripheral venous catheter.Method. On the basis of the registers used for monitoring intravenous catheters, an automated consultation was realized that elaborated a list of the patients admitted, including: date of admission, date of the insertion of the venous access device, and type of device. It was implanted in January 2010 and updated three times a day with the computers of the unit. A quasi-experimental study has measured the cumulative incidence of phlebitis, extravasation and obstructions in the patients registered in 2009 and 2010. The association between qualitative variables was evaluated with the Chisquared test, and relative risk (RR) and Number Needed to Treat (NNT) were estimated. conclusion. With the help of a reminder list (which includes the patients with vascular access and the date), there has been a decrease in the number of phlebitis and extravasations but not in the number of obstructions.

Cateter periférico com sistema fechado de infusão: implementação de tecnologia

“…In terms of infiltration, there was similarity when compared to studies with 12.5% 17 and 13%, 14 but when compared to national studies, the values were lower (23.08% 5 to 35.5 % 10 ). It is inferred that the extravasation rate was lower than the findings of two international studies, which were around 10% 14,19 and higher, when compared to a prospective national observational study with clinical and surgical patients (1.9%). 5 In a multicenter study conducted in three Australian hospitals with adults, the rate of obstruction was higher than that described in this study, with 20.9% of the cases, but with no occurrence of local infection (0.0%).…”