• Title/Summary/Keyword: 말초정맥관

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Convergence factors affecting on education and nursing performance related to peripheral intravenous catheterization among pediatric nurses (아동간호사의 말초정맥관 관련 교육 및 간호수행에 영향을 미치는 융합적 요인)

  • Kim, Jeong-Hwa;Jung, In-Sook
    • Journal of the Korea Convergence Society
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    • v.10 no.10
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    • pp.321-329
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    • 2019
  • The purpose of this descriptive research conducted among 125 pediatric nurses was to get basic data for nursing educational program on peripheral intravenous catheterization. The collected data using Protocol of Pediatric Peripheral Intravenous Infusion of Choi et. al.(2016) and Core Basic Nursing skills & Protocol ; Intravenous Infusion of Korean Accreditation Board of Nursing Education(2017) were analyzed using SPSS 21.0. Nursing performance of pediatric nurses was the lowest in education, and the highest in side effect management. There were significant differences in subarea of nursing performance according to general characteristics. There was a positive correlation between education and nursing performance(r=.486, p<.001), and factors influencing nursing performance were education(${\beta}=.472$), working department(${\beta}=.216$) and marital status(${\beta}=.169$)(adj $R^2=0.314$, p<.001). These results can be used as basic data on nursing educational program on peripheral intravenous catheterization for pediatric nurses after repeated study by expanding the number of subjects.

Availability of peripheral inserted central catheters in severe hemophilia patients with inhibitors (중증 혈우병 항체 환자에서 시행한 말초삽입 중심혈관 카테터의 유용성)

  • Park, Youngshil
    • Clinical and Experimental Pediatrics
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    • v.51 no.12
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    • pp.1359-1362
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    • 2008
  • The most effective treatment strategy for patients with hemophilia is replacement therapy with FVIII or FIX concentrates, which usually requires long-term, uncomplicated venous access. However, central venous access device (CVADs, ports) insertion requires inpatient admission and general anesthesia, and presents some problems regarding health insurance coverage. Peripherally inserted central catheters (PICCs) were inserted in two severe hemophilia patients aged 7 and 11 years with high titers of inhibitors. They experienced frequent bleeding episodes and required replacement therapy, which eventually resulted in difficulty in acquiring venous line access. Factor VIII activity was below 1%, and inhibitor titers were 160 and 26.3 BU/ml. In an outpatient setting, PICC lines are easily placed by radiological guidance and require local anesthesia alone. PICC has been feasible, in particular, for hemophilia patients with frequent bleeding episodes.

Factors Associated with Central Venous Catheterization in Cancer Patients (암환자의 중심정맥관 삽입 예측요인)

  • Park, Jeong-Yun;Park, Yeon-Hwan
    • Asian Oncology Nursing
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    • v.11 no.1
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    • pp.1-8
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    • 2011
  • Purpose: The purpose of this study was to identify the types of venous access devices (VAD) for cancer patients and investigate the factors related to the insertions of central venous catheter (CVC) in cancer patients. Methods: The subjects were 379 cancer patients. A retrospective review of all patients who were discharged from a cancer unit from November 1st to 21st in 2008 was done using a structured questionnaire. Results: A total of 82 CVC (21.6%) was inserted among 379 patients for administering anticancer therapy. There were statistically significant differences in age, length of stay (LOS), cumulative LOS, medical department, history of CVC insertion, cancer category, and albumin level between patients using peripheral intravenous (IV) catheters and CVC. In addition, factors influencing the use of CVC were LOS (odds ratio [OR]=0.286, confidence interval [CI]=1.043-1.124), history of CVC insertion (OR=3.920, CI=0.128-0.637), albumin level (OR=1.010, CI=1.879-8.179), cumulative LOS (OR=1.010, CI=1.001-1.018), and hematological diseases (OR=4.863, CI=2.162-10.925). Conclusion: We found that central venous catheterization for anticancer therapy was minimal even though CVC was safe and effective device for IV access. It is necessary to develop a strategy to use VADs efficiently and timely for cancer patients.

Analysis of PICC Inserted Patient Data in a Hospital by IV CNS-Driven Intervention (정맥주입 전문간호사가 삽입한 말초삽입형 중심정맥관(PICC) 사용 결과에 대한 후향적 분석)

  • Park, Jeong-Yun;Park, Kwang-Ok;Baek, Mi-Kyung;Kim, Se-Ra;Kwon, Hye-Li;Yang, Su-Ji
    • Journal of Korean Biological Nursing Science
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    • v.6 no.1
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    • pp.33-42
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    • 2004
  • Background : Intravenous(IV) access is becoming an increasingly important part of health care today. The current drive for clinical effectiveness and cost-effective health care serves to increase the need for reliable vascular access. Venous access devices were developed to overcome problems associated with limited peripheral access and frequent venipuncture in patients with long-term therapy. Although the peripherally inserted central catheter(PICC) have become popular during recent years in USA, its procedure is rare in Korea. Purpose : The goal of this study was to analyze the PICC inserted patient data by IV CNS intervention. Method : A Total of 62 PICCs were inserted into 51 patients by the IV CNS during a 10-month period form November, 14, 2002, to October 2, 2002. Data was obtained retrospectively through chart review. Result : The patient population included 34(54.8%) men and 28(45.2%) women, with a mean age 50.6 years. The main indication for PICC placement was to access vein in poor peripheral venous status(40.3%). The mean served interval for PICC insertions was 16.7 days(range, $2{\sim}61$ days). The reasons for removal were completed therapy in 18 cases(29.0%), patient death in 13 cases(21.0%), and mechanical or functional PICC problem in 10cases(16.1%). The three PICCs removed for presumed infection, and one had only positive tip cultures(0.2%). Conclusion : PICCs are rapidly growing popularity and required an extended course of IV therapy.

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Veno-venous Extracorporeal Membrane Oxygenation with a Double Lumen Catheter for Pediatric Pulmonary Support (급성호흡부전 환아에게 이중관 캐뉼라로 시행한 정맥간 체외막형산화장치)

  • Choi, Min-Suk;Yang, Ji-Hyuk;Jun, Tae-Gook;Lee, Young-Tak;Ahn, Kang-Mo
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.168-171
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    • 2010
  • The number of cases of extracorporeal membrane oxygenation (ECMO) has rapidly increased all over Korea since the introduction of peripheral cannulation catheters. However, the application of ECMO to children has been limited due to the shortage of pediatric equipment and difficulty in maintaining an ECMO system with peripheral cannulation. For this reason, there have been only few reports of pediatric ECMO in Korea, and most of them pertained to the veno-arterial type ECMO for supporting the cardiac system in postcardiotomy patients. We report here on the successfully performing veno-venous ECMO, with using a double lumen percutaneous catheter, in a child with acute respiratory distress syndrome.

The Development of Phlebitis in Relation to 18 Gauge Peripheral Intravenous Catheter Dwell Time among Surgical Patients (수술환자 18 Gauze 말초 정맥관 유지시간과 정맥염 발생률)

  • Choi, Jung Hee;Kang, Min Ja;Park, Youn Hee;Hong, Bo Ra;Lee, Dong Sook
    • Journal of Korean Clinical Nursing Research
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    • v.21 no.2
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    • pp.188-195
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    • 2015
  • Purpose: The purpose of this study was to evaluate the appropriateness of the replacement time intervals of 18 gauge peripheral intravenous catheters (PICs) by investigating the development of phlebitis. Methods: The subjects were 200 hospitalized patients over 18 yrs old aged who have 18 gauge PICs placed for surgery. After the insertion of PICs, the researcher monitored the insertion site daily for 96 hours for any signs of phlebitis. Results: Phlebitis developed in 25.7% of patients. Patients who developed phlebitis were significantly older and were receiving fluids with faster infusion rate. However, patients with and without phlebitis were not different by gender, insertion site, fluid osmolality, or pH of drugs administered. The incidence rate of phlebitis was higher than 10%(12.9%) starting 24~48 hours after the insertion of 18 gauge PICs. Conclusion: It is recommended to replace 18 gauge PICs within 24~48 hours after insertion. Close monitoring of the PICs insertion site for the signs of phlebitis is recommended.

Study on Prolonging Peripheral Intravenous Catheter Indwell Time Based on Phlebitis Rate (정맥염 발생률에 근거한 말초 정맥관의 정규교환 시기 연장에 대한 연구)

  • Yoon, Hee Sook;Park, Mee Ah;Park, Eun Jung;Choi, Jhin Hee;Kim, Mi Young;Lim, Ji Mi;Lee, Seung Ja;Lee, Chang Kwan
    • Journal of Korean Clinical Nursing Research
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    • v.16 no.1
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    • pp.145-153
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    • 2010
  • Purpose: The purpose of this study was to re-assess the replacement time intervals of Peripheral Intravenous Catheters (PICs) by investigating phlebitis rates according to the indwelling times of PICs. Methods: The study was conducted on 340 patients in S hospital by an IV team. After PIC insertion, IV team members evaluated once a day. The PICs were replaced every 96 hours, and let them in situ when the patients wanted to, in the absence of any sign of complications, from 97 hours to 153 hours. Results: Total phlebitis rate was 19.6%. There were no significantly different factors associated with the occurrence of phlebitis. The incidence rates of phlebitis were 12.6% and 7.0% before and after 72 hours of PIC insertion, and recorded zero after 96 hours. Conclusion: It would be recommendable to maintain PIC in situ for longer than 72 hours if there is no sign of complication such as phlebitis in close monitoring of PIC insertion site.

Factors Related to Extravasation of Non-chemotherapy Vesicant Drugs in Peripheral Vein Catheters (말초 정맥주사를 통해 비항암제 발포성 약물을 투약한 성인 환자의 일혈 발생과 위험요인)

  • Lee, Jong Min;Lee, JuHee;Jang, Yeon Soo;Kim, Yeon Hee
    • Journal of Korean Critical Care Nursing
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    • v.11 no.2
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    • pp.11-20
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    • 2018
  • Purpose : This study aimed to investigate the incidence of intravenous extravasation and the risk factors associated with the use of peripheral intravenous catheters in adults. Method : This prospective observational study included 203 adult patients admitted to the general ward who received non-chemotherapy vesicant drug infusion treatments. Data were analyzed using frequencies, percentage, means, standard deviations, and odds ratios (ORs) from multiple logistic regressions. Results : The incidence of extravasation was 43.3%. Risk factors for intravenous extravasation included continuous injections (OR=5.35, 95% CI [1.38, 20.83]), and parenteral nutrition (OR=3.53, 95% CI [1.43, 8.73]). Conclusion : The present findings revealed that gastrointernal medicine problems, continuous injection, and parenteral nutrition were related to intravenous extravasation. Further research is necessary to reduce the incidence of extravasation related to peripheral intravenous catheterization in adults, and to prevent secondary complications. Finally, patients should be provided appropriate and continuous care based on the type of intravenous infusion.

Effect of Observation Window at Peripheral Intravenous Catheter Site on Early Recognition of Infiltration among Hospitalized Children (아동의 말초정맥관 삽입 부위 관찰창 확보가 침윤조기감지에 미치는 효과)

  • Jeong, Ihn Sook;Park, Soon Mi;Park, Kyung Ju
    • Journal of Korean Academy of Nursing
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    • v.46 no.4
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    • pp.534-541
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    • 2016
  • Purpose: The aim of this study was to identify the effect of an observation window (OW) at peripheral intravenous (IV) catheter sites on early detection of IV infiltration among hospitalized children. Methods: This was a retrospective observational study with history control group design. Participants were children who had IV infiltration after peripheral catheterization when hospitalized from January to May, 2014 and January to May, 2015 at a children's hospital located in Yangsan city, Korea. The 193 patients, who were hospitalized from January to May, 2014 formed the control group and did not have OW, and the 167 patients, who were hospitalized from January to May, 2015 formed the window group and had OW. Data were analyzed using ${\chi}^2$-test, independent samples t-test and multiple logistic regression. Results: First stage IV infiltration was 39.5% for the window group and 25.9% for the control group, which was significantly different (p=.007). The likelihood of $2^{nd}$ stage and above IV infiltration decreased by 44% in the window group, which was significantly different (p=.014). Conclusion: OW at the peripheral IV catheter site was found to be an effective measure in early recognition of IV infiltration. Considering the effect of OW, we recommend that nurses should make an OW with transparent dressing during stabilization of the IV catheter site in hospitalized children in clinical settings.

Analysis of Central Line-associated Bloodstream Infection among Infants in the Neonatal Intensive Care Unit: A Single Center Study

  • Kim, Minhye;Choi, Sujin;Jung, Young Hwa;Choi, Chang Won;Shin, Myoung-jin;Kim, Eu Suk;Lee, Hyunju
    • Pediatric Infection and Vaccine
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    • v.28 no.3
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    • pp.133-143
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    • 2021
  • Purpose: This study aimed to determine the incidence of central line-associated bloodstream infection (CLABSI) in the neonatal intensive care unit (NICU), evaluate the patients' clinical characteristics, and identify the etiologic agents for guidance in prevention and treatment. Methods: A retrospective chart review study of infants classified as having CLABSI was conducted at the NICU of Seoul National University Bundang Hospital from January 2016 to December 2020. Results: Of the 45 infants, 53 had CLABSIs within a follow-up period of 18,622 catheter days. The incidence of CLABSIs was 2.85 per 1,000 catheter days. The most common catheter type was a peripherally inserted central catheter (n=47, 81%). A total of 57 pathogens were isolated, of which 57.9% (n=33) were Gram-positive bacteria, 36.8% (n=21) were Gram-negative bacteria, and 5.3% (n=3) were Candida spp. The most common pathogens were Staphylococcus aureus (n=12, 21%) and coagulase-negative staphylococci (n=12, 21%), followed by Klebsiella aerogenes (n=8, 14%). The median duration of bacteremia was 2 days, and 19 episodes showed bacteremia for 3 days or more. The mortality rate of infants within 14 days of CLABSI was 13.3% (n=6). Conclusions: This study analyzed the incidence of CLABSI and the distribution of pathogens in the NICU. Continuous monitoring of CLABSI based on active surveillance serves as guidance for empiric antibiotic use and also serves as a tool to assess the necessity for implementation of prevention strategies and their impact.