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Intravenous Nurse

G Suleyman, R Kenney, M J Zervos, A Weinmann
WHAT IS KNOWN AND OBJECTIVE: Outpatient parenteral therapy (OPAT) has become a safe and effective modality for patients requiring intravenous or prolonged antimicrobial therapy since the 1970s. It is being increasingly utilized in various settings; however, studies evaluating the safety and efficacy of clinic-based OPAT are limited. Since 2012, patients being considered for OPAT have required an infectious disease (ID) consultation at our institution. Candidates receiving once-daily antimicrobials who were ineligible for home infusion or nursing home placement as determined by their insurance companies and those who preferred the clinic over nursing home or home infusion were referred to the ID clinic...
October 16, 2016: Journal of Clinical Pharmacy and Therapeutics
Andrea Russo, Domenico Luca Grieco, Francesca Bevilacqua, Gian Marco Anzellotti, Annamaria Scarano, Giovanni Scambia, Barbara Costantini, Elisabetta Marana
PURPOSE: This retrospective study aims to compare postoperative pain relief offered by continuous intravenous infusion of either fentanyl or morphine. METHODS: Sixty American Society of Anesthesiologists Physical Status I and II women who had undergone open gynecological surgery were enrolled. All patients received total intravenous postoperative analgesia for 24 h with continuous infusion of either fentanyl or morphine at comparable doses (38 patients received 0...
October 14, 2016: Journal of Anesthesia
Amy O'Donnell, Catherine McParlin, Stephen C Robson, Fiona Beyer, Eoin Moloney, Andrew Bryant, Jennifer Bradley, Colin Muirhead, Catherine Nelson-Piercy, Dorothy Newbury-Birch, Justine Norman, Emma Simpson, Brian Swallow, Laura Yates, Luke Vale
BACKGROUND: Nausea and vomiting in pregnancy (NVP) affects up to 85% of all women during pregnancy, but for the majority self-management suffices. For the remainder, symptoms are more severe and the most severe form of NVP - hyperemesis gravidarum (HG) - affects 0.3-1.0% of pregnant women. There is no widely accepted point at which NVP becomes HG. OBJECTIVES: This study aimed to determine the relative clinical effectiveness and cost-effectiveness of treatments for NVP and HG...
October 2016: Health Technology Assessment: HTA
Aiqun Zhu, Ting Wang, Shali Wen
Peripheral intravenous catheters (PIVC) are widely used in clinical nursing, but indwelling time remains a subject of debate. This study aimed to assess the risk factors for PIVC phlebitis in adults and provide a basis for indwelling time decisions. A total of 189 first-time PIVC patients in the emergency ward were assessed between May and October 2015. Data were retrieved for patient characteristics and PIVC assessment records. This study showed that over two-thirds (67.72%) of PIVCs were removed because of phlebitis, including oedema (37...
October 10, 2016: International Journal of Nursing Practice
Ihn Sook Jeong, Gey Rok Jeon, Man Seop Lee, Bum Joo Shin, Yong-Jin Kim, Soon Mi Park, Sookyung Hyun
: This study was aimed to examine the cumulative risk for infiltration over IV catheter dwell time by general or catheterization-specific characteristics of pediatric patients with IV therapy. DESIGN AND METHODS: This secondary data analysis was done with the data of 1596 children who received peripheral IV therapy at least once during their hospital stay between August 1st and October 30th, 2011 and in June, 2013 in an academic medical center, Yangsan, Republic of Korea...
September 17, 2016: Journal of Pediatric Nursing
Lisa Wolf, Connie M Ulrich, Christine Grady
Excellent patient care within the emergency department requires interdisciplinary training, teamwork, and communication to manage the chaos of the environment. Specifically, invasive procedures required to manage airway, breathing, and circulation via intubation, chest compressions, and establishing intravenous access can provide a direct benefit to save lives but also have the potential to harm both patients and health care clinicians alike; emergency health care clinicians can be exposed to significant amounts of blood and body fluids as well as other threats of physical and psychological harm...
September 2016: Hastings Center Report
Hidenori Tanabe, Ryoko Murayama, Koichi Yabunaka, Makoto Oe, Toshiaki Takahashi, Chieko Komiyama, Hiromi Sanada
INTRODUCTION: Peripheral intravenous catheters (PIVCs) are frequently removed due to phlebitis. We hypothesized that catheters made of polyurethane, which is more flexible than Teflon, would decrease phlebitis, and that flexibility could be estimated by measuring the catheter-tip angle. Ultrasonography in two groups of patients with different catheter types was then used to compare catheter-tip angles and phlebitis. METHODS: Observational studies were carried out at a medical ward in a university hospital...
September 20, 2016: Journal of Vascular Access
Loreto Arias-Fernández, Belén Suérez-Mier, María Del Carmen Martínez-Ortega, Alberto Lana
OBJECTIVE: To determine the incidence and risk factors of phlebitis associated to the care of peripheral vascular catheters (PVC). METHOD: Prospective cohort study at the Central University Hospital of Asturias (Spain). A total of 178PVC were observed daily until their extraction. The incidence of phlebitis was measured using the Visual Infusion Phlebitis Scale, that distinguishes between gradei (possible phlebitis) andii (phlebitis). The independent diagnoses of phlebitis made by staff nurses were also collected...
September 15, 2016: Enfermería Clínica
Marieberta Vidal, David Hui, Janet Williams, Eduardo Bruera
CONTEXT: Decreased oral intake is very common at the end of life. Dehydration can aggravate symptoms such as fatigue, myoclonus and confusion. Intravenous hydration at home can be logistically difficult and expensive. Hypodermoclysis (HDC) is easy to provide and inexpensive; however, it is rarely used to provide hydration at the end of life in the home setting. OBJECTIVES: The purpose of this study was to determine if caregivers were capable of administering hypodermoclysis in the home hospice setting...
September 15, 2016: Journal of Pain and Symptom Management
Lisa Kirwan, Imelda Coyne
Restraint is often perceived as necessary to ensure that medical procedures are carried out safely. The limited research into nurses' perceptions of restraint practices with hospitalized children hinders understanding the extent of the problem. A survey design was used to investigate nurses' perceptions of restraint use from five units in one children's hospital in Ireland. Findings revealed that restraint is a common practice, with physical and psycho- logical restraints most commonly used and newborn to 4-year-old children most likely to be restrained...
September 16, 2016: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
Andrew P Smith, Catherine A Millares-Sipin, Marian James, Henry Cohen
OBJECTIVES: Evaluate the clinical impact of pharmacist-initiated vancomycin monitoring and dosing in a long-term care setting. DESIGN: Single-center, pretest, post-test design. SETTING: Rutland Nursing Home, Brooklyn, New York. PARTICIPANTS: Nursing facility residents treated with intravenous vancomycin (N = 198). OUTCOME MEASURES: The primary objective is to determine the incidence of acute kidney injury (AKI) a year before and a year after implementation of a pharmacist-initiated vancomycin-monitoring protocol...
September 2016: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Petra Duran-Gehring, Laurie Bryant, Jennifer A Reynolds, Petra Aldridge, Colleen J Kalynych, Faheem W Guirgis
OBJECTIVES: To report our success and complication rates with emergency department (ED) technician-performed ultrasound (US)-guided peripheral intravenous (IV) catheter placement and to compare our results to similar studies in the literature. METHODS: We conducted a retrospective review of a prospective database of patients who underwent US-guided peripheral IV catheter placement attempts for clinical care in the ED. All patients meeting difficult IV access criteria who had a US-guided peripheral IV catheter placement attempted by a trained ED technician were included...
September 14, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Yayoi Ohashi, Leyla Baghirzada, Hiroyuki Sumikura, Mrinalini Balki
Japan has seen significant developments in obstetric anesthesia in recent years, including the establishment of the Japanese Society of Obstetric Anesthesia and Perinatology. However, labor pain, which is one of the most important issues in obstetric practice, is still not treated aggressively. The rate of epidural administration for labor analgesia is very low in Japan as compared to other developed countries. Remifentanil has been used for labor analgesia, as part of general anesthesia for cesarean delivery, as well as for various fetal procedures around the world...
September 12, 2016: Journal of Anesthesia
Ihn Sook Jeong, Soon Mi Park, Kyung Ju Park
PURPOSE: The aim of this study was to identify the effect of an observation window (OW) at peripheral intravenous (IV) catheter sites on early detection of IV infiltration among hospitalized children. METHODS: This was a retrospective observational study with history control group design. Participants were children who had IV infiltration after peripheral catheterization when hospitalized from January to May, 2014 and January to May, 2015 at a children's hospital located in Yangsan city, Korea...
August 2016: Journal of Korean Academy of Nursing
L Pasquesoone, N Aljudaibi, J Ellart, P Guerreschi, V Duquennoy-Martinot
The subcutaneous diffusion of intravenous drips, or extravasation, is a frequent iatrogenic complication in children, mainly in the neonatal period. This potentially severe pathology can lead to local ischemia that sometimes mimics compartment syndrome. It can also evolve towards vast soft-tissue necrosis. Nursing staff often underestimate the risk of functional, aesthetic, and psychological consequences. The speed and quality of the initial medical and surgical management can greatly decrease morbidity associated with extravasation...
October 2016: Annales de Chirurgie Plastique et Esthétique
Cynthia M LaFond, Catherine Van Hulle Vincent, Kimberly Oosterhouse, Diana J Wilkie
: The purpose of this study was to provide a current and comprehensive evaluation of nurses' beliefs regarding pain in critically ill children. DESIGN AND METHODS: A convergent parallel mixed-methods design was used. Nurse beliefs were captured via questionnaire and interview and then compared. RESULTS: Forty nurses participated. Most beliefs reported via questionnaire were consistent with effective pain management practices. Common inaccurate beliefs included the need to verify pain reports with physical indicators and the pharmacokinetics of intravenous opioids...
September 3, 2016: Journal of Pediatric Nursing
Thomas P Cundy, Kyra Sierakowski, Alexandra Manna, Celia M Cooper, Laura L Burgoyne, Sanjeev Khurana
BACKGROUND: Standardized post-operative protocols reduce variation and enhance efficiency in patient care. Patients may benefit from these initiatives by improved quality of care. This matched case-control study investigates the effect of a multidisciplinary criteria-led discharge protocol for uncomplicated appendicitis in children. METHODS: Key protocol components included limiting post-operative antibiotics to two intravenous doses, avoidance of intravenous opioid analgesia, prompt resumption of diet, active encouragement of early ambulation and nursing staff autonomy to discharge patients that met assigned criteria...
September 6, 2016: ANZ Journal of Surgery
Natalie A Masco
Acid-base homeostasis is essential to normal function of the human body. Even slight alterations can significantly alter physiologic processes at the tissue and cellular levels. To optimally care for patients, nurses must be able to recognize signs and symptoms that indicate deviations from normal. Nurses who provide infusions to patients-whether in acute care, home care, or infusion center settings-have a responsibility to be able to recognize the laboratory value changes that occur with the imbalance and appreciate the treatment options, including intravenous infusions...
September 2016: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
John H Boyd, Demetrios Sirounis, Julien Maizel, Michel Slama
BACKGROUND: In critically ill patients at risk for organ failure, the administration of intravenous fluids has equal chances of resulting in benefit or harm. While the intent of intravenous fluid is to increase cardiac output and oxygen delivery, unwelcome results in those patients who do not increase their cardiac output are tissue edema, hypoxemia, and excess mortality. Here we briefly review bedside methods to assess fluid responsiveness, focusing upon the strengths and pitfalls of echocardiography in spontaneously breathing mechanically ventilated patients as a means to guide fluid management...
September 4, 2016: Critical Care: the Official Journal of the Critical Care Forum
Zarko Alfirevic, Edna Keeney, Therese Dowswell, Nicky J Welton, Nancy Medley, Sofia Dias, Leanne V Jones, Gillian Gyte, Deborah M Caldwell
BACKGROUND: More than 150,000 pregnant women in England and Wales have their labour induced each year. Multiple pharmacological, mechanical and complementary methods are available to induce labour. OBJECTIVE: To assess the relative effectiveness, safety and cost-effectiveness of labour induction methods and, data permitting, effects in different clinical subgroups. METHODS: We carried out a systematic review using Cochrane methods. The Cochrane Pregnancy and Childbirth Group's Trials Register was searched (March 2014)...
August 2016: Health Technology Assessment: HTA
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