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Abstract
Objective: To evaluate the prevalence and impact of midline catheters inserted by the Infusion and Vascular Access Team using echo-guided puncture compared to conventional intravenous strategies (peripheral venous catheter insertion by hospitalization nurses) in a nephrology and kidney transplant unit.
Material and Method: This is a retrospective observational study. Three periods were compared: pre-implementation, implementation, and consolidation of the Infusion and Vascular Access Team. All patients admitted to the Nephrology and Kidney Transplantation hospitalization units requiring the placement of peripheral vascular catheters and midline were included. The prevalence of venous access, dwell time, and reasons for removal (complications) were analyzed.
Resultados: The incidence of peripheral vascular catheters decreased while that of midlines progressively increased in all three periods. Moreover, there were no differences in the mean dwell time of peripheral vascular catheters, whereas the dwell time of midlines increased. A higher and variable rate of complications was confirmed in peripheral vascular catheters in all periods, while in midlines, the complication rate was lower and more stable.
Conclusions: Implementing an intravenous therapy program in nephrology patients has allowed for minimizing the number of venous devices per patient, resulting in a reduction in punctures during hospitalization and a decrease in complications associated with venous cannulation (lower morbidity).
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Copyright (c) 2024 Yolanda Amarilla Tostado, Emma Gomà Freixes, Mónica Gastelo Anhuamán, Alicia Fernández Bombin, María Angels Llauradó González, Blanca Sampedro Sanchis
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References
- Grupo de trabajo de la Guía de Práctica Clínica sobre Terapia Intravenosa con Dispositivos no Permanentes en Adultos. Guía de Práctica Clínica sobre Terapia Intravenosa con Dispositivos no Permanentes en Adultos. Madrid: Ministerio de Sanidad, Servicios Sociales e Igualdad. Agencia de Evaluación de Tecnologías Sanitarias de Andalucía (AETSA); 2014.
- Ferrer C, Almirante B. Infecciones relacionadas con el uso de los catéteres vasculares. Enferm Infecc Microbiol Clin. 2014;32 (2):115-24. DOI: https://doi.org/10.1016/j.eimc.2013.12.002
- Manrique Rodríguez S, Heras Hidalgo I, Pernía López MS, Herranz Alonso A, Del Rio Pisabarro MC, et al. Standardization and Chemical Characterization of Intravenous Therapy in Adult Patients: A Step Further in Medication Safety. Drugs R D. 2021;21(1):39-64. DOI: https://doi.org/10.1007/s40268-020-00329-w
- Porras C. Estudio descriptivo y análisis económico de la introducción de un catéter MidLine de 10 cm en un hospital de tercer nivel de Barcelona. Rev Enferm Vasc 2023;5(7):5-10.
- Carrero Caballero MC. Tratado de Administración parenteral. 2ª Edición. Madrid: Difusión Avances de Enfermería (DAE); 2013.
- García González RF, Gago Fornells M. Catéteres venosos periféricos. En: García González F, Gago Fornells M. Actualización de conocimientos en terapia intravenosa. Madrid: IDER Cursos, Sociedad Española de Enfermería de Equipos de Terapia Intravenosa (ETI) 2018. pp. 15-19.
- GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020; 29;395(10225):709-33. DOI: https://doi.org/10.1016/S0140-6736(19)32977-0
- Ortiz A; Asociación Información Enfermedades Renales Genéticas (AIRG-E), European Kidney Patients’ Federation (EKPF), Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón (ALCER), Fundación Renal Íñigo Álvarez de Toledo (FRIAT), Red de Investigación Renal (REDINREN) et al. RICORS2040: the need for collaborative research in chronic kidney disease. Clin Kidney J. 2021 Sep 23;15(3):372-87.
- Jager KJ, Kovesdy C, Langham R, Rosenberg M, Jha V, Zoccali C. A single number for advocacy and communication-worldwide more than 850 million individuals have kidney diseases. Nephrol Dial Transplant. 2019;34:1803-5. DOI: https://doi.org/10.1093/ndt/gfz174
- Fortes Escalona N, Fernández Domínguez JM, Cruzado Álvarez C, García Matez S. Uso de catéteres venosos de línea media en pacientes hospitalizados. Enferm glob. 2019;18(56):1-18. DOI: https://doi.org/10.6018/eglobal.18.4.334891
- DeVries M, Lee J, Hoffman L. Infection free midline catheter implementation at a community hospital (2 years). Am J Infect Control. 2019;47(9):1118-21. DOI: https://doi.org/10.1016/j.ajic.2019.03.001
- Scoppettuolo G, Pittiruti M, Pitoni S, Dolcetti L, Emoli A, Mitidieri A, Migliorini I, Annetta MG. Ultrasound-guided “short” midline catheters for difficult venous access in the emergency department: a retrospective analysis. Int J Emerg Med. 2016;9(1):3. DOI: https://doi.org/10.1186/s12245-016-0100-0
- Chopra V, Kaatz S, Swaminathan L, Boldenow T, Snyder A, Burris R, Bernstein SJ, Flanders S. Variation in use and outcomes related to midline catheters: results from a multicentre pilot study. BMJ Qual Saf. 2019;28(9):714-20. DOI: https://doi.org/10.1136/bmjqs-2018-008554
- Nielsen EB, Antonsen L, Mensel C, Milandt N, Dalgaard LS, Illum BS, Arildsen H, Juhl-Olsen P. The efficacy of midline catheters-a prospective, randomized, active-controlled study. Int J Infect Dis. 2021;102:220-5. DOI: https://doi.org/10.1016/j.ijid.2020.10.053
- O’Grady NP, Alexander M, Burns LA, Dellinger P, Garland J, Heard SO, et al. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis. 2011;52(9):e162-93. DOI: https://doi.org/10.1093/cid/cir257
- Del Río C, Corredor R, Cubero MA, Lafuente E, Lasso de la Vega L. Excelencia en la creación de Equipos de Infusión y Acceso Vascular. Barcelona: Ediciones Mayo; 2020.
References
Grupo de trabajo de la Guía de Práctica Clínica sobre Terapia Intravenosa con Dispositivos no Permanentes en Adultos. Guía de Práctica Clínica sobre Terapia Intravenosa con Dispositivos no Permanentes en Adultos. Madrid: Ministerio de Sanidad, Servicios Sociales e Igualdad. Agencia de Evaluación de Tecnologías Sanitarias de Andalucía (AETSA); 2014.
Ferrer C, Almirante B. Infecciones relacionadas con el uso de los catéteres vasculares. Enferm Infecc Microbiol Clin. 2014;32 (2):115-24. DOI: https://doi.org/10.1016/j.eimc.2013.12.002
Manrique Rodríguez S, Heras Hidalgo I, Pernía López MS, Herranz Alonso A, Del Rio Pisabarro MC, et al. Standardization and Chemical Characterization of Intravenous Therapy in Adult Patients: A Step Further in Medication Safety. Drugs R D. 2021;21(1):39-64. DOI: https://doi.org/10.1007/s40268-020-00329-w
Porras C. Estudio descriptivo y análisis económico de la introducción de un catéter MidLine de 10 cm en un hospital de tercer nivel de Barcelona. Rev Enferm Vasc 2023;5(7):5-10.
Carrero Caballero MC. Tratado de Administración parenteral. 2ª Edición. Madrid: Difusión Avances de Enfermería (DAE); 2013.
García González RF, Gago Fornells M. Catéteres venosos periféricos. En: García González F, Gago Fornells M. Actualización de conocimientos en terapia intravenosa. Madrid: IDER Cursos, Sociedad Española de Enfermería de Equipos de Terapia Intravenosa (ETI) 2018. pp. 15-19.
GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020; 29;395(10225):709-33. DOI: https://doi.org/10.1016/S0140-6736(19)32977-0
Ortiz A; Asociación Información Enfermedades Renales Genéticas (AIRG-E), European Kidney Patients’ Federation (EKPF), Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón (ALCER), Fundación Renal Íñigo Álvarez de Toledo (FRIAT), Red de Investigación Renal (REDINREN) et al. RICORS2040: the need for collaborative research in chronic kidney disease. Clin Kidney J. 2021 Sep 23;15(3):372-87.
Jager KJ, Kovesdy C, Langham R, Rosenberg M, Jha V, Zoccali C. A single number for advocacy and communication-worldwide more than 850 million individuals have kidney diseases. Nephrol Dial Transplant. 2019;34:1803-5. DOI: https://doi.org/10.1093/ndt/gfz174
Fortes Escalona N, Fernández Domínguez JM, Cruzado Álvarez C, García Matez S. Uso de catéteres venosos de línea media en pacientes hospitalizados. Enferm glob. 2019;18(56):1-18. DOI: https://doi.org/10.6018/eglobal.18.4.334891
DeVries M, Lee J, Hoffman L. Infection free midline catheter implementation at a community hospital (2 years). Am J Infect Control. 2019;47(9):1118-21. DOI: https://doi.org/10.1016/j.ajic.2019.03.001
Scoppettuolo G, Pittiruti M, Pitoni S, Dolcetti L, Emoli A, Mitidieri A, Migliorini I, Annetta MG. Ultrasound-guided “short” midline catheters for difficult venous access in the emergency department: a retrospective analysis. Int J Emerg Med. 2016;9(1):3. DOI: https://doi.org/10.1186/s12245-016-0100-0
Chopra V, Kaatz S, Swaminathan L, Boldenow T, Snyder A, Burris R, Bernstein SJ, Flanders S. Variation in use and outcomes related to midline catheters: results from a multicentre pilot study. BMJ Qual Saf. 2019;28(9):714-20. DOI: https://doi.org/10.1136/bmjqs-2018-008554
Nielsen EB, Antonsen L, Mensel C, Milandt N, Dalgaard LS, Illum BS, Arildsen H, Juhl-Olsen P. The efficacy of midline catheters-a prospective, randomized, active-controlled study. Int J Infect Dis. 2021;102:220-5. DOI: https://doi.org/10.1016/j.ijid.2020.10.053
O’Grady NP, Alexander M, Burns LA, Dellinger P, Garland J, Heard SO, et al. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis. 2011;52(9):e162-93. DOI: https://doi.org/10.1093/cid/cir257
Del Río C, Corredor R, Cubero MA, Lafuente E, Lasso de la Vega L. Excelencia en la creación de Equipos de Infusión y Acceso Vascular. Barcelona: Ediciones Mayo; 2020.