Multidisciplinary cooperative mode led by infusion nurse specialists used to ensure the nursing quality of peripherally inserted central catheters in China: A 5-year retrospective study

Abstract

Objective:

To analyze the effect of multidisciplinary cooperation mode (MCM) led by infusion nurse specialists (INSs) on peripherally inserted central catheters (PICC) catheterization and indwelling nursing quality.

Methods:

Participants’ demographic information, catheter types, catheterization approaches, puncture site, tip position, professional title of nurses, success rate of catheterization, consultation rate, detection rate of complications and outcome improvement rate of 6576 outpatients and hospitalized patients with PICC were analyzed retrospectively by a software named “questionnaire stars,” in a large tertiary general hospital in Shanghai, from January 2015 to December 2019. SPSS 26.0 for Windows was used for data collection and description, Chi-square test were used for statistical analysis of enumeration data, and p < 0.05 was statistically significant.

Results:

According to the catheter types’ data, the use rate of three-way valve catheters decreased from 79.9% to 14.5%, while the use rate of three-way valve solo catheters increased from 12.7% to 51.6%, and the use rate of power injectable and open-ended catheters increased from 7.4% to 33.9%. According to the data of PICC catheterization method, conventional technology decreased significantly from 16.8% to 1.1%, modified Seldinger technique (MST) increased gradually from 26.1% to 51.3%, while ultrasound guided modified Seldinger technique (US and MST) decreased slightly from 57.2% to 47.6%. 7.5% catheter tip ends were malpositioned while nine indwelled PICCs were traced to have tip end malposition. The consultation rate was significantly higher than that before applying MCM led by INSs (x² = 151.713, p < 0.05). After applying MCM led by INSs, the detection rate of complications was significantly higher than before (x² = 5.499, p < 0.05), the rate of successful insertion at one time was significantly higher than before (x² = 187.589, p < 0.05).

Conclusion:

After the application of INSs-led MCM, progresses have been achieved. The nursing quality of patients’ PICC was significantly improved than before.

Keywords

Multidisciplinary cooperative mode infusion nurse specialists nursing quality peripherally inserted central catheters

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References

Paolo

Gianni

Gianluca

, et al. Peripherally inserted central catheter-related thrombosis rate in modern vascular access era-when insertion technique matters: a systematic review and meta-analysis. J Vasc Access 2020; 21(1): 45–54.

Zhang

Cheng

, et al. Investigation and analysis of the medical practices of the standardized nursing practices for intravenous therapy in western region hospitals of china. J Chinese Nurs Manage 2018; 18(5): 632–635.

Sun

Wang

Guan

, et al. A survey of the status of infusion therapy in tertiary hospitals in China. Chin J Nurs 2014; 10: 1232–1237.

Westergaard

Classen

Walther-Larsen

Peripherally inserted central catheters in infants and children: indications, techniques, complications and clinical recommendations. Acta Anaesthesiol Scand 2013; 57(3): 278–287.

Zhou

Zhang

, et al. Evaluation on effectiveness and safety of peripherally inserted central catheters technology: an overview of systematic review. J Nurs Sci 2016; 31(7): 90–94.

Periard

Monney

Waeber

, et al. Randomized controlled trial of peripherally inserted central catheters vs. peripheral catheters for middle duration in-hospital intravenous therapy. J Thromb Haemost 2008; 6(8): 1281–1288.

Chopra

Kuhn

Ratz

, et al. Vascular access specialist training, experience, and practice in the United States: results from the national PICC1 survey. J Infus Nurs 2017; 40(1): 15–25.

Molina Caballero

Martinez

Merino M

Perez

Martinez A

, et al. Peripherally inserted central catheters: savings, comfort, many advantages. Cir Pediatr 2016; 29(3): 96–100.

Park

Kim

. A comprehensive review of clinical nurse specialist-led peripherally inserted central catheter placement in Korea: 4101 cases in a tertiary hospital. J Infus Nurs 2015; 38(2): 122–128.

10.

Sharp

Grech

Fielder

, et al. The patient experience of a peripherally inserted central catheter (PICC): a qualitative descriptive study. Contemp Nurse 2014; 48: 26–35.

11.

Santos

FKY

Flumignan

RLG

Areias

, et al. Peripherally inserted central catheter versus central venous catheter for intravenous access: a protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99(30): 1–7.

12.

. The current status of peripherally inserted central catheter application among 147 tertiary Grade A hospitals in China. Chin Nurs Manag 2016; 16(6): 729–732.

13.

Lin

. Advances of placement of peripherally inserted central catheter using bedside ultrasound and modified Seldinger technique. J Nurs Sci 2010; 25(9): 89–91.

14.

Gorski

Hadaway

Hagle

, et al. Infusion therapy standards of practice. J Infus Nurs 2016; 39(Suppl. 1): S1–S159.

15.

Wei

Wang

Guixin

, et al. Research in reason analysis and prevention of phlebitis caused by PICC in cancer patients undergoing chemotherapy. Chin J Pract Nurs 2010; 26(8): 5–9.

16.

Gao

Wei

, et al. Investigation and analysis of the influencing factors of PICC catheter-related infection in cancer patients. Chin J Nosocomial Infective Sci 2012; 22(11): 2290–2292.

17.

Rong-qing

Dai-qi

Yujie

. Clinical observation and nursing for catheter-related blood stream infection (CRBSI) caused by different pathogenic bacteria in patients with PICC. Chin J Nurs 2016; 51(11): 1368–1370.

18.

Liqun

Ruo

Songmei

, et al. Summary of the best evidence for risk assessment of PICC related thrombus. Chin J Nurs 2017; 52(10): 1179–1185.

19.

Liem

Yanit

Moseley

, et al. Peripherally inserted central catheter usage patterns and associated symptomatic upper extremity venous thrombosis. J Vasc Surg 2012; 55(3): 761e7.

20.

Gregory

Nicole

Imran

, et al. Peripherally inserted central catheters inserted with current best practices have low deep vein thrombosis and central line-associated bloodstream infection risk compared with centrally inserted central catheters: a contemporary meta-analysis. J Vasc Access 2021; 22(1): 9–25.

21.

Tricia

Jennifer

Claire

, et al. Peripherally inserted central catheter thrombosis after placement via electrocardiography vs traditional methods. Am J Med 2021; 134(2): e79–e88.

22.

Hong

Shuling

Jing

, et al. The incidence and related factors of PICC catheter misplacement. J Nurs Adm (China) 2011; 11(3): 203–204.

23.

Gonsalves

Eschelman

Sullivan

, et al. Incidence of central vein stenosis and occlusion following upper extremity PICC and port placement. Cardiovasc Intervent Radiol 2003; 26(2): 123–127.

24.

Mou

Wang

, et al. Nerve damage secondary to removal of fractured PICC fragment. J Vasc Access 2016; 17(4): e79–e81.

25.

Minghui

Hujun

Lim

, et al. Iatrogenic acute cardiac tamponade during percutaneous removal of a fractured peripherally inserted central catheter in a premature neonate. Heart & Lung 2015; 44(6): 517–520.

26.

Zhao

Huang

, et al. Prevalence of medical adhesive-related skin injury at peripherally inserted central catheter insertion site in oncology patients. J Vasc Access 2018; 19(1): 23–27.

27.

Ziling

. Analysis of related factors and preventive strategies for iatrogenic skin injury in patients with PICC. Nurs Pract Res (China) 2019; 16(1): 21–23.

28.

Dawson

. PICC zone insertion method^TM (ZIM^TM): a systematic approach to determine the ideal insertion site for PICCs in the upper arm. JAVA 2011; 16(3): 156–165.