scholarly journals Direct cost of peripheral catheterization by nurses

2019 ◽  
Vol 72 (1) ◽  
pp. 88-94
Author(s):  
Ana Beatriz Mateus Pires ◽  
Antônio Fernandes Costa Lima

ABSTRACT Objective: To measure the average direct cost of peripherally inserted central catheterization performed by nurses in a pediatric and neonatal intensive care unit. Method: A quantitative, exploratory-descriptive, single-case study, whose sample consisted of the non-participant observation of 101 peripherally inserted central catheter procedures. The cost was calculated by multiplying the execution time (timed using a chronometer) spent by nursing professionals, participants in the procedure, by the unit cost of direct labor, added to the cost of materials, drugs, and solutions. Results: The average direct cost of the procedure was US$ 326.95 (standard deviation = US$ 84.47), ranging from US$ 99.03 to US$ 530.71, with a median of US$ 326.17. It was impacted by material costs and the direct labor of the nurses. Conclusion: The measurement of the average direct cost of the peripherally inserted central catheter procedure shed light on the financials of consumed resources, indicating possibilities of intervention aiming to increase efficiency in allocating these resources.

2020 ◽  
Vol 73 (5) ◽  
Author(s):  
Antônio Fernandes Costa Lima ◽  
Amanda Saba ◽  
Abílio Gonçalves das Neves Filho ◽  
Karen Aparecida Couto ◽  
Luciana Oliveira e Silva

ABSTRACT Objectives: to analyze the mean direct cost and peripheral venous access length outcomes using devices over needle with and without extension. Methods: quantitative, exploratory-descriptive research. Venous punctures and length of the devices were followed. The mean direct cost was calculated by multiplying the time (timed) spent by nursing professionals by the unit cost of labor, adding to the cost of materials. Results: the total mean direct cost of using devices “with extension” (US$ 9.37) was 2.9 times the cost of using devices “without extension” (US$ 4.50), US$ 7.71 and US$ 2.66, respectively. Totaling 96 hours of stay, the “device over needle with extension” showed a lower occurrence of accidental loss. Conclusions: the use of the “device over needle with extension”, despite its higher mean direct cost, was more effective in favoring adequate length of peripheral venous access.


2018 ◽  
Vol 26 (0) ◽  
Author(s):  
Antônio Fernandes Costa Lima

ABSTRACT Objective: to analyze the mean direct cost of the constituent procedures of conventional hemodialysis, performed in three public teaching and research hospitals. Method: quantitative, exploratory-descriptive study, of the multiple case study type. The mean direct cost was calculated by multiplying the time (timed) spent by nursing professionals, on the execution of procedures, by the unit cost of direct labor, added to the cost of materials and solutions/medications. Results: the total mean direct cost, in patients with an arteriovenous fistula corresponded to US$25.10 in hospital A, US$37.34 in hospital B and US$25.01 in hospital C, and in patients with a dual lumen catheter, US$32.07 in hospital A, US$40.58 in hospital B and US$30.35 in hospital C. The weighted mean values obtained were US$26.59 for hospital A, US$38.96 for hospital B and US$27.68 for hospital C. It was noted that the “installation and removal of hemodialysis fistula access” caused a significantly lower economic impact compared to “installation and removal of hemodialysis catheter access”. Conclusion: with the knowledge developed it will be possible to support hospital managers, technical managers and nursing professionals in the decision making process, with a view to the rational allocation of the necessary inputs for the performance of conventional hemodialysis.


2018 ◽  
Vol 26 (0) ◽  
Author(s):  
Rafael Fernandes Bel Homo ◽  
Antônio Fernandes Costa Lima

ABSTRACT Objective: to identify the average direct cost of maintaining the patency of totally implanted central venous catheter with heparin at a Day Hospital of a public hospital of high complexity specialized in the treatment of cancer patients, and estimate the average direct cost of replacing heparin with sodium chloride 0.9%. Method: quantitative, exploratory-descriptive study, with a sample of 200 non-participant observations of the maintenance of totally implanted central venous catheters with heparin. The average direct cost was calculated by multiplying the (clocked) time spent by professionals to complete the procedure by the direct unit cost of workforce, added to the cost of materials and solutions. Results: the estimated total direct cost of catheter maintenance with heparin was US$ 9.71 (SD=1.35) on average, ranging from US$ 7.98 to US$ 23.28. The estimated total direct cost of maintenance with 0.9% sodium chloride in the place of heparin was US$ 8.81 (SD=1.29) on average, resulting in a reduction of US$ 0.90 per procedure. Conclusion: the results contributed to propose strategies to assist in cost containment/minimization in this procedure. The replacement of heparin by 0.9% sodium chloride proved to be an option to reduce the total average direct cost.


2014 ◽  
Vol 48 (1) ◽  
pp. 104-109 ◽  
Author(s):  
Áquila Lopes Gouvêa ◽  
Antônio Fernandes Costa Lima

Quantitative research that aimed to identify the mean total cost (MTC) of connecting, maintaining and disconnecting patient-controlled analgesia pump (PCA) in the management of pain. The non-probabilistic sample corresponded to the observation of 81 procedures in 17 units of the Central Institute of the Clinics Hospital, Faculty of Medicine, University of Sao Paulo. We calculated the MTC multiplying by the time spent by nurses at a unit cost of direct labor, adding the cost of materials and medications/solutions. The MTC of connecting was R$ 107.91; maintenance R$ 110.55 and disconnecting R$ 4.94. The results found will subsidize discussions about the need to transfer money from the Unified Health System to hospitals units that perform this technique of analgesic therapy and it will contribute to the cost management aimed at making efficient and effective decision-making in the allocation of available resources.


2015 ◽  
Vol 23 (3) ◽  
pp. 475-482 ◽  
Author(s):  
Priscila Costa ◽  
Amélia Fumiko Kimura ◽  
Debra Huffman Brandon ◽  
Eny Dorea Paiva ◽  
Patricia Ponce de Camargo

OBJECTIVE: to develop a risk score for unplanned removal of peripherally inserted central catheter in newborns.METHOD: prospective cohort study conducted in a neonatal intensive care unit with newborn babies who underwent 524 catheter insertions. The clinical characteristics of the newborn, catheter insertion and intravenous therapy were tested as risk factors for the unplanned removal of catheters using bivariate analysis. The risk score was developed using logistic regression. Accuracy was internally validated based on the area under the Receiver Operating Characteristic curve.RESULTS: the risk score was made up of the following risk factors: transient metabolic disorders; previous insertion of catheter; use of a polyurethane double-lumen catheter; infusion of multiple intravenous solutions through a single-lumen catheter; and tip in a noncentral position. Newborns were classified into three categories of risk of unplanned removal: low (0 to 3 points), moderate (4 to 8 points), and high (≥ 9 points). Accuracy was 0.76.CONCLUSION: the adoption of evidence-based preventative strategies based on the classification and risk factors faced by the newborn is recommended to minimize the occurrence of unplanned removals.


2015 ◽  
Vol 49 (3) ◽  
pp. 488-494 ◽  
Author(s):  
Mariana Fexina Tomé ◽  
Antônio Fernandes Costa Lima

OBJECTIVE Identify the direct cost of reprocessing double and single cotton-woven drapes of the surgical LAP package. METHOD A quantitative, exploratory and descriptive case study, performed at a teaching hospital. The direct cost of reprocessing cotton-woven surgical drapes was calculated by multiplying the time spent by professionals involved in reprocessing the unit with the direct cost of labor, adding to the cost of materials. The Brazilian currency (R$) originally used for the calculations was converted to US currency at the rate of US$0.42/R$. RESULTS The average total cost for surgical LAP package was US$9.72, with the predominance being in the cost of materials (US$8.70 or 89.65%). It is noteworthy that the average total cost of materials was mostly impacted by the cost of the cotton-woven drapes (US$7.99 or 91.90%). CONCLUSION The knowledge gained will subsidize discussions about replacing reusable cotton-woven surgical drapes for disposable ones, favoring arguments regarding the advantages and disadvantages of this possibility considering human resources, materials, as well as structural, environmental and financial resources.


2014 ◽  
Vol 48 (4) ◽  
pp. 699-705 ◽  
Author(s):  
Caroline Rife Nobrega ◽  
Antônio Fernandes Costa Lima

To identify the direct cost of procedures related to an outpatient chemotherapy treatment for women with breast cancer. Method: This is a quantitative research, using the case study methodology, performed in an outpatient chemotherapy of a private hospital. The total cost was calculated by multiplying the time spent by professionals involved in therapeutic procedures, the unit cost of direct labor, adding to the cost of materials, drugs and solutions. For performing the calculations, we used the Brazilian currency (R$). Results: The average total cost per chemotherapy session corresponded to R$ 1,783.01 (100%), being R$ 1,671.66 (93,75%) spent with drugs, R$ 74,98 (4.21%) with materials, R$ 28.49 (1.60%) with labor and R$ 7.88 (0.44%) with solutions. Conclusion: The results may support discussions and decision making for the management of costs related to chemotherapy aimed at reducing expenses and eliminating waste without harm to the care provided. 



2021 ◽  
Vol 11 (4) ◽  
Author(s):  
Higor Pacheco Pereira ◽  
Débora Maria Vargas Makuch ◽  
Junia Selma Freitas ◽  
Izabela Linha Secco ◽  
Mitzy Tannia Reichembach Danski

Objetivo: Identificar o conhecimento dos enfermeiros quanto à inserção e manutenção do cateter central de inserção periférica em uma Unidade de Terapia Intensiva Neonatal. Método: Estudo exploratório descritivo quantitativo realizado em um hospital pediátrico de referência em maio e junho de 2019. Análise dos dados por meio do programa SPSS (21.0). Resultados: Setenta e oito por cento dos enfermeiros receberam capacitação na instituição, 100,0% realizam lavagem do acesso com solução salina, pressão positiva e técnica pulsátil e todos consideram como pontos críticos o eritema, algia, secreção no local de inserção e obstrução do dispositivo. Conclusão: O papel do enfermeiro é fundamental na diligência com o cateter central de inserção periférica, atuando como educador da equipe de enfermagem para promover a qualificação e adesão aos protocolos institucionais continuamente.Descritores: Recém-nascido; Cateterismo venoso central; Unidades de terapia intensiva neonatal; Enfermagem neonatal.Peripherally inserted central catheter: nursing practices in neonatal intensive careObjective: To identify nursing knowledge regarding the insertion and maintenance of the peripherally inserted central catheter in a Neonatal Intensive Care Unit. Method: Exploratory descriptive quantitative study carried out in a pediatric reference hospital in May and June 2019. Data analysis using the SPSS program (21.0). Results: Seventy-eight percent of nurses received training at the institution, 100.0% performed access flushing with saline, positive pressure and pulsating technique and all considered as critical points erythema, pain, secretion at the insertion site and obstruction of the device. Conclusion: The role of the nurse is fundamental in the diligence with the peripherally inserted central catheter, acting as an educator of the nursing team to promote qualification and adherence to institutional protocols continuously.Descriptors: Newborn; Central venous catheterization; Neonatal intensive care units; Neonatal nursing.Catéter central insertado periféricamente: prácticas de enfermería en cuidados intensivos neonatalesObjetivo: identificar el conocimiento de las enfermeras sobre la inserción y el mantenimiento del catéter central insertado periféricamente en una unidad de cuidados intensivos neonatales. Metodo: estudio cuantitativo descriptivo exploratorio realizado en un hospital pediátrico de referencia en mayo y junio de 2019. Análisis de datos con el programa SPSS (21.0). Resultados: el setenta y ocho por ciento de las enfermeras recibieron capacitación en la institución, el 100.0% realizó enrojecimiento de acceso con solución salina, presión positiva y técnica pulsante y todos se consideraron puntos críticos como eritema, dolor, secreción en el sitio de inserción y obstrucción del dispositivo Conclusión: El papel de la enfermera es fundamental en la diligencia con el catéter central insertado periféricamente, actuando como un educador del equipo de enfermería para promover la calificación y el cumplimiento de los protocolos institucionales continuamente.Descriptores: Recién nacido; Cateterismo venoso central; Unidades de cuidados intensivos neonatales; Enfermería neonatal.


Author(s):  
J.L. Ruikka ◽  
C. Acun ◽  
S. Karnati

Peripherally inserted central catheter line entrapment is a rare complication in the neonatal intensive care unit and only a small number of cases have been reported. While studies have suggested recommendations for removal, there is still a need for surgical intervention in some cases. This is a case of a premature infant with long term peripherally inserted central catheter line placement with fibrin sheath formation that required multiple attempts before successful noninvasive removal and a review of the cases with difficult peripherally inserted central catheter removal in newborns.


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