REVIEW PAPER
Selected diagnostic and therapeutic procedures and the occurrence of vascular access complications in a group of critically ill patients
1
Faculty of Health Sciences, University of Bielsko-Biala, Poland
2
Department of Nursing and Epidemiological Care, Faculty of Health Sciences, Jagiellonian University Collegium Medicum, Cracow, Poland
3
Department of Clinical Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Collegium Medicum, Cracow, Poland
Corresponding author
Ewelina Bąk
University of Bielsko-Biala, Faculty of Health Sciences, Bielsko-Biala, Poland, ul. Willowa 2, 43-309 Bielsko- Biała, Poland
University of Bielsko-Biala, Faculty of Health Sciences, Bielsko-Biala, Poland, ul. Willowa 2, 43-309 Bielsko- Biała, Poland
J Pre Clin Clin Res. 2018;12(4):135-141
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Patients of intensive care units (ICU) require the use of many invasive procedures to maintain the function of inefficient organs. The use of vascular access is an indispensable part of the procedure, but it may involve the risk of lifethreatening complications.
Objective:
The aim of the study was to identify selected diagnostic and therapeutic procedures for the occurrence of vascular access complications.
Materials and metho:
A retrospective study was conducted in a 11-bed multi-profile intensive care unit in the south of Poland. The research used the analysis of individual and collective medical documentation, as well as an original questionnaire to collect the data. Statistical analysis was performed using STATISTICA 10 PL Software. .
Results:
Among 1,742 vascular accesses inserted, complications occurred in 411 cases. Among complications, the most common occurrence was infection (34%), cannula occlusion (24.2%) and accidental removal of the cannula during its use (18.3%). In relation to the examined patients, in addition to cannulation of venous and arterial vessels, mechanical ventilation, stomach and bladder probing were administered, some patients underwent surgery, had conditions following invasive cardiology procedures or required intra-aortic counter-perfusion.
Conclusions:
The multitude of interventions had a significant impact on the occurrence of vascular access complications. The incidence of vascular access complications was influenced by other therapeutic procedures, such as the length of mechanical ventilation, the need to perform tracheotomy, and catheterization of the bladder.
Patients of intensive care units (ICU) require the use of many invasive procedures to maintain the function of inefficient organs. The use of vascular access is an indispensable part of the procedure, but it may involve the risk of lifethreatening complications.
Objective:
The aim of the study was to identify selected diagnostic and therapeutic procedures for the occurrence of vascular access complications.
Materials and metho:
A retrospective study was conducted in a 11-bed multi-profile intensive care unit in the south of Poland. The research used the analysis of individual and collective medical documentation, as well as an original questionnaire to collect the data. Statistical analysis was performed using STATISTICA 10 PL Software. .
Results:
Among 1,742 vascular accesses inserted, complications occurred in 411 cases. Among complications, the most common occurrence was infection (34%), cannula occlusion (24.2%) and accidental removal of the cannula during its use (18.3%). In relation to the examined patients, in addition to cannulation of venous and arterial vessels, mechanical ventilation, stomach and bladder probing were administered, some patients underwent surgery, had conditions following invasive cardiology procedures or required intra-aortic counter-perfusion.
Conclusions:
The multitude of interventions had a significant impact on the occurrence of vascular access complications. The incidence of vascular access complications was influenced by other therapeutic procedures, such as the length of mechanical ventilation, the need to perform tracheotomy, and catheterization of the bladder.
REFERENCES (42)
1.
Mermel LA, Farr BM, Sherertz RJ, Raad II, O’Grady N, Harris JS, Craven DE. Guidelines for the management of intravascular catheter-related infections. Clin Infect Dis 2001; 32(9): 1249–1272.
2.
Deduńska K, Dyk D. Prevention of bloodstream infections associated with the maintenance of central vascular catheters – literature review. Anest Ratow 2015; 9: 420–426.
3.
Collignon PJ. Intravascular catheter associated sepsis: a common problem. The Australian Study on Intravascular Catheter Associated Sepsis. Med J Aust 1994; 161(6): 374–378.
4.
Webster J, Clarke S, Paterson D, Hutton A, van Dyk S, Gale C, Hopkins T. Routine care of peripheral intravenous catheters versus clinically indicated replacement: randomised controlled trial. BMJ 2008; 337: a399.
5.
Lim MY, Al-Kali A, Ashrani AA, Begna KH, Elliott MA, Hogan WJ, Hook CC, Kaufmann SH, Letendre L, Litzow MR, Patnaik MS, Pardanani A, Tefferi A, Wolanskyj AP, Grill DE, Pruthi RK. Comparison of complication rates of Hickman catheters versus peripherally inserted central catheters in patients with acute myeloid leukemia undergoing induction chemotherapy. Leuk Lymphoma 2013; 54(6): 1263–1267.
6.
Napalkov P, Felici DM, Chu LK, Jacobs Jr, Begelman SM. Incidence of catheter-related complications in patients with central venous or hemodialysis catheters: a health care claims database analysis. BMC Cardiovasc Disord 2013; 13: 86.
7.
Bembnowska M., Jośko-Ochojska J. Quality Management in Healthcare. Hyg Publ Health 2015; 50(3): 457–462.
8.
Cranovsky R., Krajewski R. Adverse Events in Treatment – The Scale of the Problem Med Prakt 2011; 2: 127–132.
9.
Bouch C., Thompson JP. Severity scoring system in the critically ill. Continuing Education in Anaesthesia, Critical Care & Pain 2008; 8(5):181–185.
10.
Miranda DR. The Therapeutic Intervention Scoring System: one single tool for the evaluation of workload the work process and management? Intensive Care Med 1997; 23(6): 615–617.
11.
Wieder-Huszla S. Monitoring of nosocomial infections in intensive care unit. Ann Acad Med Stetin 2010; 56(3): 20–29.
12.
Wieder-Huszla S, Jurczak A, Grochans E, Giedrys-Kalemba S. Occurrence of Infections Among Patients After Surgical Procedures Staying in the Intensive Care Unit. Probl Hig Epidemiol 2012; 93(3): 586–592.
13.
Kołpa M, Wałaszek M, Gniadek A, Wolak Z, Dobroś W. Incidence, Microbiological Profile and Risk Factors of Healthcare-Associated Infections in Intensive Care Units: A 10 Year Observation in a Provincial Hospital in Southern Poland. Int J Environ Res Public. Health. 2018; 15(1): 112 doi: 10.3390/ijerph15010112.
14.
Garnacho-Montero J, Aldabo-Pallas T, Palomar-Martinez M, Vallés J, Almirante B, Garcés R, Grill F, Pujol M, Arenas-Giménez C, Mesalles E, Escoresca-Ortega A, de Cueto M, Ortiz-Leyba C. Risk factors and prognosis of catheter-related bloodstream infection in critically ill patients: a multicenter study. Intensive Care Med 2008; 34(12): 2185–2193.
15.
Lorente L. Prevention of catheter-related infection: which catheter, which access and which insertion technique should be chosen? Reanimation 2013; 22: S409–416.
16.
Lorente L, Jimenez A, Naranjo C, Martinez J, Iribarren JL, Jimenez JJ, Santacreu R, Martin MM, Mora ML. Higher incidence of catheter-related bacteremia in jugular site with tracheostomy than in femoral site. Infect Control Hosp Epidemiol 2010; 31(3): 311–313.
17.
van der Kooi T, Wille JC, van Benthem BH. Catheter application, insertion vein and length of ICU stay prior to insertion affect the risk of catheter-related bloodstream infection. J Hosp Infect 2012; 80(3): 238–244.
18.
Ambrose C. Recruitment problem in intensive care: a solution. Nurs Stand 2002; 17(12): 39–40.
19.
Abualrub RF. Nursing shortage in Jordan: what is the solution? J Prof Nurs 2007; 23(2): 117–120.
20.
Volpatti C, Leathley M, Walley KR, Dodek PM. Time-weighted nursing demand is a better predictor than midnight census of nursing supply in an intensive care unit. J Crit Care 2000; 15(4): 147–150.
21.
Lenartowicz H. Quality Management in Nursing. Warszawa, Centrum Edukacji Medycznej 1998.
22.
Kózka M. Efficiency of Vocational Education in First Degree Nursing Studies During the Transformation of the Educational System. Uniwersyteckie Wydawnictwo Medyczne Vesalius, Kraków 2008.
23.
Pires Siqueira EM, Davies Ribeiro M, Silva Souza RC, de Souza Machado F, Diccini S. Correlation between work load of nursing and severity of critical general, neurological and cardiac patients. Esc Anna Nery 2015; 19: 233–238.
24.
Głowacka M, Orzoł A, Soleta A. Workload in the Practice of Nurses at Anaesthesiology and Intensive Care Wards. J Public Health Nurs Med Rescue 2012; 4: 5–13.
25.
Miranda DR, de Rijk A, Schaufeli W. Simplified Therapeutic Intervention Scoring System: the TISS-28 items-results from a multicenter study. Crit Care Med 1996; 24(1): 64–73.
26.
Aiken LJ, Clarke SP, Sloane DM, Sochalski J, Silber JH. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA 2002; 288(16): 1987–1993.
27.
Darvas JA., Hawkins LG. What makes a good intensive care unit: a nursing perspective. Aust Crit Care 2002; 15(2): 77–82.
28.
Cavanagh SJ. Job satisfaction of nursing staff working in hospitals. J Adv Nurs 1992; 17: 704–711.
29.
Aiken L, Sloane D, Bruynee L, Van den Heede K, Griffiths P, Busse R, Diomidous M, Kinnunen J, Kózka M, Lesaffre E, McHugh M, Moreno-Casbas M.T, Rafferty A, Schwendimann R, Tishelman C, Achterberg T, Sermeus W. RN4CAST consortium. Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. Lancet 2014; 24; 383(9931): 1824–1830.
30.
Cisek M, Przewoźniak L, Kózka M, Brzostek T, Brzyski P, Ogarek M, Gabryś T, Gajda K, Ksykiewicz-Dorota A. Workload During the Last Duty in the Opinions of Nurses Working in Hospitals Covered Involved in the RN4CAST Project. Zdr Publ Zarz 2013; 11(2): 210–224.
31.
Goncalves LA, Padilha KG. Fatores associados a carga de trabalho de enfermagem em Unidade de Terapia Intensiva. Rev Esc Enferm USP 2007; 41(1): 645–652.
32.
Szmurło D, Kostrzewska K, Wojtarowicz M, Widawska A, Kordecka A, Plisko R, Łanda K. Employment Standards of Nurses and Midwives in Hospital Wards – Proposal of Regulation in Poland. Version 1.0. Central and Eastern European Society of Technology Assessment in Health Care (CEESTAHC). Kraków 2013.
33.
Stone PW, Pogorzelska M, Kunches L, Hirschhorn LR. Hospital staffing and health care-associated infections: a systematic review of the literaturę. Clin Infect Dis 2008; 47(7): 937–944.
34.
Safdar N, Kluger DM, Maki DG. A review of risk factors for catheter-related bloodstream infection caused by percutaneously inserted, noncuffed central venous catheters: Implications for preventive strategies. Medicine Baltimore 2002; 81(16): 466–479.
35.
Trinkoff AM, Johantgen M, Storr CL, Gurses AP, Liang Y, Han K. Linking nursing work environment and patient outcomes. J Nurs Regul 2011; 2: 10–16.
36.
Choi SP, Pang SM, Cheung K, Wong TK. Stabilizing and destabilizing forces in the nursing work environment: a qualitative study on turnover intention. Int J Nurs Stud 2011; 48(10): 1290–1301.
37.
Griffiths P, Renz A, Hughes J, Rafferty AM. Impact of organisation and management factors on infection control in hospitals: a scoping view. J Hosp Infect 2009; 73(1): 1–14.
38.
Hugonnet S, Chevrolet JC, Pittet D. The effect of workload on infection risk in critically ill patients. Crit Care Med 2007; 35(1): 76–81.
39.
Needleman J, Buerhaus P, Mattke S, Stewart M, Zelevinsky K. Nurse-staffing levels and the quality of care in hospitals. N Engl J Med 2002; 346(22): 1715–1722.
40.
Fridkin SK, Pear SM, Williamson TH, Galgiani JN, Jarvis WR. The role of understaffing in central venous catheter-associated bloodstream infections. Infect Control Hosp Epidemiol 1996; 17(3): 150–158.
41.
Alonso-Echanove J, Edwards JR, Richards MJ, Brennan P, Venezia RA, Keen J, Ashline V, Kirkland K, Chou E, Hupert M, Veeder AV, Speas J, Kaye J, Sharma K, Martin A, Moroz VD, Gaynes RP. Effect of nurse staffing and antimicrobial-impregnated central venous catheters on the risk for bloodstream infections in intensive care units. Infect Control Hosp Epidemiol 2003; 24(12): 916–925.
42.
Pronovost PJ, Berenholtz SM, Goeschel C, Thom I, Watson SR, Holzmueller CG, Lyon JS, Lubomski LH, Thompson DA, Needham D, Hyzy R, Welsh R, Roth G, Bander J, Morlock L, Sexton JB. Improving patient safety in intensive care units in Michigan. J Crit Care 2008; 23(2): 207–221.
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