Intravascular device use, management, documentation and complications: a point prevalence survey
Karen A. New A B D , Joan Webster A B C , Nicole M. Marsh A C , Barbara Hewer A and on behalf of the Royal Brisbane and Women’s Hospital Intravenous Access Research CouncilA Centre for Clinical Nursing, 2nd Floor, Centre for Clinical Nursing, Building 34, Royal Brisbane and Women’s Hospital, Butterfield Street, Herston, Qld 4029, Australia. Email: Joan.Webster@health.qld.gov.au; Nicole.Marsh@health.qld.gov.au; Barbara.Hewer@health.qld.gov.au
B The University of Queensland, School of Nursing and Midwifery, 2nd Floor, Centre for Clinical Nursing, Building 34, Royal Brisbane and Women’s Hospital, Butterfield Street, Herston, Qld 4029, Australia.
C NHMRC Centre for Research Excellence in Nursing, Centre for Health Practice Innovation, Griffith Health Institute, Griffith University, 2nd Floor, Centre for Clinical Nursing, Building 34, Royal Brisbane and Women’s Hospital, Butterfield Street, Herston, Qld 4029, Australia.
D Corresponding author. Email: k.new@uq.edu.au
Australian Health Review 38(3) 345-349 https://doi.org/10.1071/AH13111
Submitted: 31 May 2013 Accepted: 2 March 2014 Published: 29 May 2014
Abstract
Objective To examine the use, management, documentation and complications for intravascular devices in cardiac, medical and surgical inpatients.
Methods A point prevalence survey was undertaken in a large tertiary hospital in Queensland. Descriptive statistics were used to analyse data.
Results Of the 327 patients assessed, 192 (58.7%) had one or more devices in situ. Of the 220 devices, 190 (86.4%) were peripheral venous catheters, 25 (11.4%) were peripherally inserted central catheters and five (2.3%) were central venous catheters. Sixty-two of 220 devices (28.2%) were in situ without a clear purpose, whereas 54 (24.7%) had one or more complications, such as redness, pain, tracking, oedema or oozing. There was no documentation on the daily patient care record to indicate that a site assessment had occurred within the past 8 h for 25% of the devices in situ.
Conclusions The present study identified several problems and highlighted areas for improvement in the management and documentation for intravascular devices. Ongoing education, promoting good clinical practice and reauditing, can be applied to improve the management of devices.
What is known about the topic? Intravascular devices are associated with health care-related infections, including rare but serious bloodstream infections Measures for reducing healthcare-associated infection related to devices include surveillance with feedback.
What does this paper add? This paper complements other surveillance data undertaken in similar-sized institutions with similar patients. Ongoing surveillance and education is required to maintain best clinical practice and management of devices.
What are the implications for practitioners? Health care-associated infections are a serious problem and have negative outcomes for both patients and organisations. Intravascular devices may be associated with bloodstream infections, so prudent clinical care and management of devices is important. All devices should be assessed at least daily for their continued need and removed promptly if no longer required.
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