Impact of an Educational Program on Nurses' Performance in Providing Peripherally Inserted Central Catheter Care for Neonates

2020 ◽  
Vol 43 (5) ◽  
pp. 275-282
Author(s):  
Somayeh Emamgholi ◽  
Sedigheh Khanjari ◽  
Hamid Haghani
2020 ◽  
Author(s):  
Mauricio Portillo ◽  
Shyam Allamaneni ◽  
Richard Goodman

UNSTRUCTURED Cunninghamella species are an extremely rare cause of fungal infections. The usual mode of transmission is through inhalation however rare cases of cutaneous spread have been reported. The objective of this clinical case report is to highlight the uniqueness of which the patient acquired the infection, the progression, and control of it. A 57-year-old male with chronic lymphocytic leukemia was found to have an abscess next to his peripherally inserted central catheter (PICC) line. The abscess culture grew back Cunninghamella and was debrided and treated with a novel antifungal. The fungal infection was controlled and the total timeframe took 28 days. Rapid recognition and prompt treatment demonstrate the prevention of rapidly progressive angioinvasian and further systemic complications. This case also proves that a novel antifungal may be appropriate in controlling the spread of Cunninghamella species.


BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e045895
Author(s):  
Rebecca Sharp ◽  
Peter Carr ◽  
Jessie Childs ◽  
Andrew Scullion ◽  
Mark Young ◽  
...  

ObjectivesDetermine the effect of the catheter to vein ratio (CVR) on rates of symptomatic thrombosis in individuals with a peripherally inserted central catheter (PICC) and identify the optimal CVR cut-off point according to diagnostic group.DesignRetrospective cohort study.Setting4 tertiary hospitals in Australia and New Zealand.ParticipantsAdults who had undergone PICC insertion.Primary outcome measureSymptomatic thrombus of the limb in which the PICC was inserted.Results2438 PICC insertions were included with 39 cases of thrombosis (1.6%; 95% CI 1.14% to 2.19%). Receiver operator characteristic analysis was unable to be performed to determine the optimal CVR overall or according to diagnosis. The association between risk of thrombosis and CVR cut-offs commonly used in clinical practice were analysed. A 45% cut-off (≤45% versus ≥46%) was predictive of thrombosis, with those with a higher ratio having more than twice the risk (relative risk 2.30; 95% CI 1.202 to 4.383; p=0.01). This pattern continued when only those with malignancy were included in the analysis, those with cancer had twice the risk of thrombosis with a CVR greater than 45%. Whereas the 33% CVR cut-off was not associated with statistically significant results overall or in those with malignancy. Neither the 33% or 45% CVR cut-off produced statistically significant results in those with infection or other non-malignant conditions.ConclusionsAdherence to CVR cut-offs are an important component of PICC insertion clinical decision making to reduce the risk of thrombosis. These results suggest that in individuals with cancer, the use of a CVR ≤45% should be considered to minimise risk of thrombosis. Further research is needed to determine the risk of thrombosis according to malignancy type and the optimal CVR for those with a non-malignant diagnosis.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Woo Jin Yang ◽  
Danbee Kang ◽  
Ji Hoon Shin ◽  
Eun Ho Jang ◽  
Seung Yeon Noh ◽  
...  

AbstractThe purpose of this study is to investigate strategies for peripherally inserted central catheter (PICC) placement in patients with venous steno-occlusive lesion (VSOL). We performed a retrospective cohort study in adults with central or peripheral VSOL who underwent PICC placement procedures from January 2015 to December 2018. Four different strategies [selecting alternative pathway/over the wire (SAP/OTW), percutaneous transluminal angioplasty (PTA), re-puncture in ipsilateral arm (RIA), and catheter placement in the contralateral arm (CICA)] were analyzed and we compared the clinical outcomes by strategy and compared the strategy between central and peripheral VSOLs. During 4 years, 258 PICC procedures performed in patients with VSOLs, 100 PICC were included in the analysis. The overall technical success rate of initial attempt with SAP/OTW was 32.2%. As a second-line technique, PTA was most frequently used in both central (100%) and peripheral (68.2%) VSOL groups. The clinical success rates within 2 months of SAP/OTW, PTA, RIA, CICA were 55.2%, 43.2%, 14.3%, and 33.3%, respectively (P = 0.24). In conclusion, when the SAP/OTW failed, the PTA can be preferred as a second-line technique for both central and peripheral VSOLs. When guidewire passage fails, the operator could adopt the RIA or CICA technique as an alternative method.


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