Journal of intravenous nursing : the official publication of the Intravenous Nurses Society
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Human factors engineering was incorporated into the design of medical devices to reduce human errors and enhance the quality of patient care. This study will discuss medication delivery through the use of the IVAC Signature Edition infusion pump and its capability to deliver safe, efficient intravenous therapy.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of two percutaneous intravenous "midline" catheters in cystic fibrosis.
Administration of intravenous antibiotics in cystic fibrosis has been facilitated by the use of midline catheters; percutaneous lines inserted through a peripheral vein and advanced into a large but noncentral vein. In a randomized study, a 23-gauge silastic catheter (Vygon EC, Cirencester, United Kingdom) was compared with the Hydrocath (Viggo-Spectromed, Swindon, United Kingdom), a 22-gauge hydrophillic coated polyurethane catheter inserted using the Seldinger technique. Fifty eight courses of intravenous antibiotics were given, 28 through the Hydrocath (median age 11 years, range 1.5-17.5 years) and 30 through the silastic catheter, (median age 11 years, range 0.5-17.5). ⋯ The Hydrocath took longer to insert and was associated with more pain on insertion. However, administration of antibiotics was easier through the Hydrocath and overall satisfaction was higher in those who had the Hydrocath. Both catheters performed well, but administration of antibiotics was easier through the Hydrocath.
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When questions arose in the spring of 1990 concerning central venous catheter infections at a 414-bed, midwestern hospital, it was found that no hospital-wide prospective study of this problem had ever been completed. A descriptive, prospective study was conducted over 6 months, from October 1990 to April 1991, to determine the rate of infection associated with short-term central venous catheters at the study hospital. Additional research questions sought to examine the influence of certain risk factors on central venous catheter infection rates. ⋯ Correlation of infection with risk factors was not possible because of the small number of infections. The clinical line infection rates found in this study compare favorably with other rates reported in the literature. Although the presence of any exceptional problem with central line infections at the hospital was not supported by this study, the number of lines placed during the study emphasizes the importance of high-quality central venous catheter placement and maintenance technique throughout the institution.
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Difficulty with removing peripherally inserted central catheters is being encountered with increasing frequency. The most common cause of this phenomenon is venous spasm. Although gentle traction may overcome mild spasm, aggressive pulling is contraindicated. Methods and maneuvers to alleviate spasm are discussed, the simplest of which is to attempt catheter removal again after a short (20 to 30 minutes) or intermediate (12 to 24 hours) length of time, at which time spasm may have spontaneously abated.
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Comparative Study
A comparison of nurse and patient: perceptions of postsurgical pain.
In this study, the nurses' and patients' perceptions of a patient's postsurgical pain were compared. Responses to the McGill Pain Questionnaire, Present Pain Intensity (MPQ-PPI) and the Visual Analogue Scale (VAS) indicated that nurses scored patients lower on the average than patients scored themselves, both before pain medication and after pain relief. As expected, the scores on the MPQ-PPI and VAS were highly correlated, except for patients' scores before administration of medication.