Document Detail


Efficacy of multifaceted interventions in reducing complications of peripherally inserted central catheter in adult oncology patients.
MedLine Citation:
PMID:  19787379     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate the efficacy of multifaceted interventions in reducing complications of peripherally inserted central venous catheter (PICC) in adult oncology patients.
METHODS: Multifaceted interventions were implemented in our department in December 2006. These interventions include: (1) A mandatory nurse reeducation was developed by a multidisciplinary task force; (2) Modification of peripherally inserted central catheter insertion: take a chest X-ray before removal of the guidewire and cutting of the catheter. The guidewire in the catheter facilitates the accurate location of the tip of PICC on chest X-ray and make the malposition correction (withdrawing, reinsertion, even reinsertion following withdrawal) easily; (3) Using a 2% chlorhexidine preparation, replace 10% povidone iodine for skin antisepsis; (4) Maintenance of maximum sterile barrier precautions during PICC insertion and aftercare; (5) Designing of a PICC archive form and establishing a PICC archive for each patient. The PICC complication rates of groups before and after interventions were evaluated and compared.
RESULTS: Sixty-nine PICC lines were inserted before these interventions, and 165 were inserted after implementation of these interventions. Compared with preintervention group, the postintervention group was associated with a 62.14% decrease in the overall complication rate (11.52% vs 30.43% [P = 0.0004]; incidence density, 1.82 vs 4.62 per 1,000 PICC days) with a 67.48% decrease in the infective complications rate (4.24% vs 13.04% [P = 0.015]) with a 58.19% decrease in the noninfective complications rate (7.27% vs 17.39% [P = 0.0199]).
CONCLUSIONS: The results suggest that these interventions implemented in this study may be help in reducing complications of PICC in adult oncology patients.
Authors:
Geng Tian; Yan Zhu; Li Qi; Fengqin Guo; Haidan Xu
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-09-29
Journal Detail:
Title:  Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer     Volume:  18     ISSN:  1433-7339     ISO Abbreviation:  Support Care Cancer     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-08-18     Completed Date:  2010-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9302957     Medline TA:  Support Care Cancer     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1293-8     Citation Subset:  IM    
Affiliation:
Department of Tumor, The First Affiliated Hospital of Shenzhen University, Shenzhen, People's Republic of China. gengtian71@yahoo.com.cn
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anti-Infective Agents, Local / administration & dosage
Catheter-Related Infections / prevention & control*
Catheterization, Central Venous / adverse effects,  instrumentation,  methods*
Catheterization, Peripheral / adverse effects,  instrumentation,  methods*
Chlorhexidine / administration & dosage
Education, Nursing, Continuing / methods
Female
Humans
Middle Aged
Neoplasms / drug therapy
Povidone-Iodine / administration & dosage
Radiography, Thoracic / methods
Skin / microbiology
Skin Diseases, Infectious / etiology,  prevention & control*
Chemical
Reg. No./Substance:
0/Anti-Infective Agents, Local; 25655-41-8/Povidone-Iodine; 55-56-1/Chlorhexidine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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