scholarly journals Construction of a nursing care instrument for patients with central venous catheters

Rev Rene ◽  
2022 ◽  
Vol 23 ◽  
pp. e70967
Author(s):  
Stefhanie Conceição de Jesus ◽  
Kátia Cilene Godinho Bertoncello ◽  
Fernanda Alves Ferreira Gonçalves ◽  
Aline Daiane Colaço ◽  
Geline Nascente Soares Lentz ◽  
...  

Objective: to build a nursing care instrument for patients with short-term central venous catheters in an Intensive Care Unit. Methods: a multi-method study in three stages: structuring of the instrument; pre-testing of the instrument; agreement analyses among nurses and final composition of the instrument. Results: the instrument, in its first version, presented three domains related to the moment of insertion (five items), maintenance (15 items) and catheter removal (ten items). Most of the 30 items were assessed as relevant (23/77%) and presented a satisfactory Content Validity Index (28/93%). Ten items were reformulated, 32 new items were included, and three items were deleted. Conclusion: the instrument was constructed, which presented response validity for the care of nurses to patients with central venous catheters in Intensive Care Units, consisting of three domains and 59 items evaluated by nurses and considered appropriate for the moments of insertion, maintenance and removal of the catheter.

2021 ◽  
pp. 0310057X2110242
Author(s):  
Adrian D Haimovich ◽  
Ruoyi Jiang ◽  
Richard A Taylor ◽  
Justin B Belsky

Vasopressors are ubiquitous in intensive care units. While central venous catheters are the preferred route of infusion, recent evidence suggests peripheral administration may be safe for short, single-agent courses. Here, we identify risk factors and develop a predictive model for patient central venous catheter requirement using the Medical Information Mart for Intensive Care, a single-centre dataset of patients admitted to an intensive care unit between 2008 and 2019. Using prior literature, a composite endpoint of prolonged single-agent courses (>24 hours) or multi-agent courses of any duration was used to identify likely central venous catheter requirement. From a cohort of 69,619 intensive care unit stays, there were 17,053 vasopressor courses involving one or more vasopressors that met study inclusion criteria. In total, 3807 (22.3%) vasopressor courses involved a single vasopressor for less than six hours, 7952 (46.6%) courses for less than 24 hours and 5757 (33.8%) involved multiple vasopressors of any duration. Of these, 3047 (80.0%) less than six-hour and 6423 (80.8%) less than 24-hour single vasopressor courses used a central venous catheter. Logistic regression models identified associations between the composite endpoint and intubation (odds ratio (OR) 2.36, 95% confidence intervals (CI) 2.16 to 2.58), cardiac diagnosis (OR 0.72, CI 0.65 to 0.80), renal impairment (OR 1.61, CI 1.50 to 1.74), older age (OR 1.002, Cl 1.000 to 1.005) and vital signs in the hour before initiation (heart rate, OR 1.006, CI 1.003 to 1.009; oxygen saturation, OR 0.996, CI 0.993 to 0.999). A logistic regression model predicting the composite endpoint had an area under the receiver operating characteristic curve (standard deviation) of 0.747 (0.013) and an accuracy of 0.691 (0.012). This retrospective study reveals a high prevalence of short vasopressor courses in intensive care unit settings, a majority of which were administered using central venous catheters. We identify several important risk factors that may help guide clinicians deciding between peripheral and central venous catheter administration, and present a predictive model that may inform future prospective trials.


2006 ◽  
Vol 34 (1) ◽  
Author(s):  
Agnes van den Hoogen ◽  
Tannette G. Krediet ◽  
Cuno S.P.M. Uiterwaal ◽  
Jeroen F.G.A. Bolenius ◽  
Leo J. Gerards ◽  
...  

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