1.Venous injury caused by peripheral intravenous indwelling catheter and recovery
Gaiting ZHAO ; Bin LI ; Xinrong QI ; Qian HU ; Cuilan WANG
Chinese Journal of Modern Nursing 2019;25(29):3733-3738
Objective? To observe the correlation factors of venous injury caused by peripheral intravenous indwelling catheter, so as to guide the rational use of clinical intravenous indwelling catheter, so as to avoid venous injury and promote vascular recovery. Methods? This study was carried out in five Class Ⅲ Grade A hospitals. In each hospital, we randomly selected one of the departments: Digestive Internal Medicine, Nephrology, Hepatobiliary Surgery, Extraglandular Surgery and Respiratory Medicine as the research departments. The inpatients admitted from March to June 2018 were selected and included in the study as a whole with the consent of the patients. In this study, 81 qualified patients were successfully injected with the peripheral intravenous indwelling catheter infusion and observed. According to the prescription of the doctors and hospital department policies, peripheral intravenous indwelling catheter was used for infusion. Specialists were arranged to record the patients' infused solution, evaluate the puncture site of the indwelling catheter before puncture and the results of venous blood vessel evaluation before puncture. Observe and record the reasons for the removal of indwelling catheter, the patency during the removal, the indwelling time, the marking of indwelling vein, evaluate and record the condition of the puncture site of indwelling catheter and the grade of phlebitis. The elasticity and filling degree of venous vessels were evaluated and recorded on the 14th day after catheter removal. Results?(1)The severity of local phlebitis was positively correlated with the severity of vascular injury when removing intravenous indwelling catheter; the incidence of moderate and severe vascular injury was 9.09% when local symptoms were grade Ⅰ phlebitis; the incidence of moderate and severe vascular injury was 95.83% when local symptoms were grade Ⅱ and Ⅲ phlebitis when removing intravenous indwelling catheter; and there was statistical difference in the incidence of moderate and severe vascular injury between the two groups (P<0.01). (2)No moderate or severe vascular injury occurred after asymptomatic removal of intravenous indwelling catheter, and the vascular recovery rate was 100.00%. The incidence of moderate or severe vascular injury was 42.37% and the vascular recovery rate was 57.63% in patients with symptomatic removal of intravenous indwelling catheter. There was a statistically significant difference in the incidence of venous injury and recovery between the two groups (P< 0.01). (3)There was no significant difference between the indwelling time of intravenous indwelling catheter and the incidence of phlebitis and the rate of vascular injury and recovery during the time period of this clinical study (P>0.05). Conclusions? Phlebitis after peripheral intravenous indwelling catheter infusion is the main cause of vascular injury and hinders venous recovery. Preventive measures should be taken in clinical puncture and use of venous indwelling needles; the removal of indwelling catheters should not be based only on indwelling time; the symptoms of puncture sites and patients' reactions should be evaluated in accordance with the regulations to avoid phlebitis above grade Ⅱ; in order to avoid vascular injury caused by infusion of peripheral intravenous indwelling catheters, asymptomatic removal of intravenous indwelling catheter is recommended.
2.Interpretation of Expert Consensus on Venous Catheter Maintenance
Hong SUN ; Lei WANG ; Shengxiao NIE ; Lifen CHEN ; Caixia GUO ; Qiaofang YANG ; Xuying LI ; Gaiting ZHAO ; Ganhong MEI ; Ying CHEN ; Hong XING ; Bilong FENG
Chinese Journal of Modern Nursing 2020;26(36):5004-5010
This article interpretsthe expert consensus on venous catheter maintenance, including flushing and locking tube, dressing replacement and catheter maintenance, infusion connectors, catheter removal, education and training, infection control, etc. It is hoped that the expert consensus can provide a reference for clinical nurses to standardize the operations of intravenous catheter maintenance, thereby benefiting patients.