Araştırma Makalesi
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Nursing Interventions and Patient Experinces in Complications of Peripheral Intravenous Catheterization

Yıl 2023, Cilt: 13 Sayı: 3, 395 - 405, 21.09.2023
https://doi.org/10.33631/sabd.1209368

Öz

Aim: This study was carried out to determine the interventions of nurses in peripheral intravenous catheterization complications and patient experiences.
Material and Methods: This research, which was planned in a descriptive quantitative and qualitative design, was conducted with nurses working in medical clinics and inpatients. The study data, which was completed with 86 nurses and 61 patients, were collected by the forms and a semi-structured interview form created by the researchers. The data collection process was carried out between June and August 2021. Ethics committee approval, institutional permission, verbal and written informed consent were obtained from nurses and patients before starting the study.
Results: Oncology and hematology clinics showed the most complications with phlebitis (52.3%), infiltration (39.5%), extravasation (30.2%), thrombophlebitis (26.7%) and sepsis (12.8%), respectively; It was determined that the most applied interventions were stopping the fluid flow, removing the catheter immediately, placing the catheter from another area and applying cold. Conditions that negatively affect patients were; symptoms such as having a sensitive and invisible vascular structure, experiencing pain and stress in practice, delayed recovery in complications, swelling, itching and burning.
Conclusion: Peripheral intravenous catheter complications that cause pain and stress in patients, increase the burden of care for nurses and affect the quality of care can be prevented and improved with nursing care. As a result of this study, it is recommended to provide in-service training to nurses about catheter complications and nursing interventions and to inform patients about the practice.

Kaynakça

  • Chopra V, Flanders SA, Saint S, Woller SC, O’Grady NP, Safdar N, et al. The michigan appropriateness guide for intravenous catheters (MAGIC): Results from a multispecialty panel using the RAND/UCLA appropriateness method. Ann Internal Med. 2015; 163(6Supplement): S1-40.
  • Lv L, Zhang J. The incidence and risk of infusion phlebitis with peripheral intravenous catheters: A meta-analysis. The Journal of Vascular Access. 2020; 21(3): 342-9.
  • Simin D, Milutinović D, Turkulov V. Brkić S. Incidence, severity and risk factors of peripheral intravenous cannula-induced complications: an observational prospective study. Journal of Clinical Nursing. 2019; 28(9-10): 1585-99.
  • İşeri A, Çınar B, Düzyaka DS, Sözeri E, Uğur E, Bay F, ve ark. Ulusal damar erişimi yönetimi rehberi. Hastane İnfeksiyonları Dergisi. 2019; 23(1): 1-54.
  • Mattox EA. Complications of peripheral venous access devices: Prevention, detection, and recovery strategies. Critical Care Nurse. 2017; 37(2): e1–e14.
  • Perez Fidalgo JA, Garcia Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines working group. management of chemotherapy extravasation: ESMO EONS clinical practice guidelines. European Journal of Oncology Nursing. 2012; 16(5): 528-34.
  • Sarı D, Eşer İ, Akbıyık A. Phlebitis associated with peripheral intravenous catheters and nursing care. Journal of Human Sciences. 2016; 13(2): 2905-20.
  • Parreira P, Sousa LB, Marques IA, Santos-Costa P, Braga LM, Cruz A, et al. Double-chamber syringe versus classic syringes for peripheral intravenous drug administration and catheter flushing: a study protocol for a randomised controlled trial. Trials. 2020; 21(78): 1-10.
  • Infusion Therapy Standards of Practice [Internet]. Infusion Nurses Society. Journal of Infusion Nursing; 2016 [Updated: 2016 Feb; Cited 2022 Jan 20]. Available from: https://source.yiboshi.com/20170417/1492425631944540325.pdf.
  • Abe-Doi M, Murayama R, Komiyama C, Sanada H. Incidence, risk factors, and assessment of induration by ultrasonography after chemotherapy administration through a peripheral intravenous catheter. Jpn J Nurs Sci. 2020; 17: e12329.
  • Hwang EJ, Shin CI, Choi YH, Park CM. Frequency, outcome, and risk factors of contrast media extravasation in 142,651 intravenous contrast-enhanced CT scans. European Radiology. 2018; 28(12): 5368-75.
  • Australian Commission on Safety and Quality in Health Care [Internet]. Sydney; Management of Peripheral Intravenous Catheters Clinical Care Standard; 2021 [Updated: 2021 May; Cited 2022 Apr 28]. Available from: https://www.safetyandquality.gov.au/sites/default/files/202105/management_of_peripheral_intravenous_catheters_clinical_care_standard_-_accessible_pdf.pdf
  • Tosun B, Arslan BK, Özen N. Periferik venöz kateter kaynaklı flebit gelişme durumu ve hemşirelerin kanıta dayalı uygulamalara ilişkin bilgi düzeyleri: Nokta prevalans çalışması. Turkiye Klinikleri Hemşirelik Bilimleri. 2020; 12(1): 72-82.
  • Marsh N, Webster J, Ullman AJ, Mihala G, Cooke M, Chopra V, et al. Peripheral intravenous catheter non‐infectious complications in adults: A systematic review and meta‐analysis. Journal of Advanced Nursing. 2020; 76(12): 3346-62.
  • Berşe S, Tosun B, Tosun N. Periferik intravenöz katetere bağlı flebit oranının ve etkileyen faktörlerin değerlendirilmesi. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi. 2020; 13(3): 160-9.
  • Johann DA, Danski MTR, Vayego SA, Barbosa DA, Lind J. Risk factors for complications in peripheral intravenous catheters in adults: secondary analysis of a randomized controlled trial. Revista latino-americana de Enfermagem 2016; 24: e2833.
  • Onesti MG, Carella S, Fioramonti P, Scuderi N. Chemotherapy extravasation management: 21-year experience. Annals of Plastic Surgery. 2017; 79(5): 450-7.
  • Erdoğan BC, Baykara ZG. Periferik intravenöz kateter ilişkili flebit gelişimini önlemede hemşirelik bakımı. Gazi Sağlık Bilimleri Dergisi. 2020; 5(1): 30-6.
  • Kuş B, Büyükyılmaz F. Periferik intravenöz kateter uygulamalarında güncel kılavuz önerileri. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2019; 8(3): 326-32.
  • Alexandrou E, Ray-Barruel G, Carr PJ. Use of short peripheral intravenous catheters: Characteristics, management, and outcomes worldwide. Journal of Hospital Medicine. 2018; 13(5): E1-E7.
  • Marsh N, Webster J, Larsen E, Cooke M, Mihala G, Rickard C. Observational study of peripheral intravenous catheter outcomes in adult hospitalized patients: A multivariable analysis of peripheral intravenous catheter failure. Journal of Hospital Medicine. 2018; 13(2): 83-9.
  • Blanco-Mavillard I, Parra-Garcia G, Fernandez-Fernandez I, Rodriguez-Calero MA, Personat-Labrador C, Castro-Sanchez E. Care of peripheral intravenous catheters in three hospitals in Spain: Mapping clinical outcomes and implementation of clinical practice guidelines. PloS One. 2020; 15(10): e0240086.
  • Arpa Y, Cengiz A. İntravenöz infüzyon tedavisine bağlı flebit ve tromboflebit gelişimini önleme ve tanılamada sağlık çalışanlarının bilgi düzeylerinin belirlenmesi. Hemşirelikte Eğitim ve Araştırma Dergisi. 2016; 13(1): 21-6.
  • Abadi P, Etemadi S, Abed Saeedi ZH. Investigating role of mechanical and chemical factors in the creation of peripheral vein in flammarion in hospitalization patients in hospital in Zahedan, Iran. Life Science Journal. 2013; 10(1): 379-83.
  • Braga L, Parreira P, Oliveira ASS, Mónico LSM, Sena CA, Henriques MA. Phlebitis and infiltration: Vascular trauma associated with the peripheral venous catheter. Rev Lat Am Enfermagem. 2018; 26(2): 1-8.
  • Avşar G, Gümüş K, Özer N, Aytekin A. Periferik venöz kateter uygulamaya ilişkin hemşirelerin durumlarının belirlenmesi. Gümüşhane Üniversitesi Sağlık Bilimleri Derg. 2013; 2(4): 499-507.
  • Aygün G, Karaşahin K, Dikmen Y, Yaşar H, Sıdan A, Midilli K, ve ark. Yoğun bakım ünitesinde periferik venöz kateterlerin infeksiyon yönünden değerlendirilmesi. Flora. 2004; 9(1): 43-6.
  • Abolfotouh MA, Salam M, Ala’a Bani-Mustafa DW, Balkhy HH. Prospective study of incidence and predictors of peripheral intravenous catheter-induced complications. Therapeutics and Clinical Risk Management. 2014; 10: 993.
  • Annisa F, Nurhaeni N, Wanda D. Warm water compress as an alternative for decreasing the degree of phlebitis. Comprehensive Child and Adolescent Nursing. 2017; 40(sup1): 107-13.
  • Gauttam VK, Vati DJ. A study to assess and compare the effectiveness of moist heat versus icepacks application in reducing the signs and symptoms of intravenous cannulation induced thrombophlebitis among patients admitted in çivil hospital of Dausa District, Rajasthan. IRA-International Journal of Applied Sciences. 2019; 3(3): 410-23.
  • Babu JM, Bansa P, Khan F, Husain M. A quasi-experimental study to assess the effectiveness of hot fomentation versus cold compress in reducing infiltration among patients undergoing IV infusion in a Selected Hospital of Delhi. Research and reviews. Journal of Surgery. 2016: 5(1): 24-30.
  • Rukhsana RJ, Tamang EL, Kochhar A. A quasi-experimental study to assess the effectiveness of cold application versus glycerin magnesium sulphate application in relieving phlebitis among patients receiving intravenous therapy in a selected hospital of Delhi. Research and reviews. Journal of Surgery. 2016; 5: 1-5.
  • Sharma A. A comparative study to assess the effectiveness of cold application, heparinoid application and magnesium-sulphate application on superficial thrombophlebitis among patients admitted in selected hospitals of Gujarat. International Journal of Nursing Education. 2016; 8(3): 118-21.
  • O’Grady NP, Alexander M, Burns LA, Dellinger P, Gardland J, Heard SO, et al. Guidelines for the prevention of intravascular catheter-related infections. Clinical Infectious Diseases. 2017; 39(4 Suppl 1): S1-34.
  • Cura ŞÜ, Atay S, Efil S. Hemşirelerin periferik venöz kateter uygulamasına ilişkin beceri durumlarının incelenmesi; gözlemsel bir çalışma. Ankara Sağlık Bilimleri Derg. 2019; 8(2): 30-8.
  • Gorski LA. The 2016 Infusion Therapy Standards of Practice. Home Healthcare Now. 2017; 35(1): 10-8.

Periferik İntravenöz Kateterizasyon Komplikasyonlarında Hemşirelik Girişimleri ve Hasta Deneyimleri

Yıl 2023, Cilt: 13 Sayı: 3, 395 - 405, 21.09.2023
https://doi.org/10.33631/sabd.1209368

Öz

Amaç: Bu çalışma, hemşirelerin periferik intravenöz kateterizasyon komplikasyonlarında uyguladıkları girişimleri ve hasta deneyimlerini belirlemek amacıyla yapılmıştır.
Gereç ve Yöntemler: Tanımlayıcı nicel ve nitel desende planlanan bu araştırma, dahili kliniklerde çalışan hemşireler ve yatan hastalar ile yapılmıştır. 86 hemşire ve 61 hasta ile tamamlanan çalışma verileri, araştırmacılar tarafından oluşturulan formlar ve yarı yapılandırılmış görüşme formu ile toplanmıştır. Araştırmanın veri toplama süreci, Haziran-Ağustos 2021 tarihleri arasında gerçekleştirilmiştir. Çalışmaya başlamadan önce etik kurul onayı, kurum izni, hemşire ve hastalardan sözlü ve yazılı bilgilendirilmiş onam alınmıştır.
Bulgular: Sırasıyla flebit (%52,3), infiltrasyon (%39,5), ekstravazasyon (%30,2), tromboflebit (%26,7) ve sepsis (%12,8) ile en fazla komplikasyon gözlenen kliniğin onkoloji ve hematoloji klinikleri olduğu; en fazla uygulanan girişimlerin ise sırasıyla sıvı akışını durdurma, kateteri hemen çıkarma, kateteri başka bir bölgeden yerleştirme ve soğuk uygulama yapma olduğu belirlendi. Hastaları olumsuz etkileyen durumlar ise; hassas ve görünmeyen damar yapısına sahip olma, uygulamada ağrı ve stres yaşama, komplikasyonlarda geç iyileşme, şişlik, kaşıntı ve yanma gibi belirtiler olarak belirlendi.
Sonuç: Hastalarda ağrı ve strese neden olan ve hemşireler için bakım yükünü arttıran, bakım kalitesini etkileyen periferik intravenöz kateterizasyon komplikasyonları önlenebilir ve hemşirelik bakımı ile iyileştirilebilir. Bu çalışma sonucunda hemşirelere kateter komplikasyonları ve hemşirelik girişimlerine ilişkin hizmet içi eğitimlerin ve hastalara uygulamaya yönelik bilgilendirilmelerin yapılması önerilmektedir.

Teşekkür

Yazarlar, çalışmaya katılan hemşire ve hastalara teşekkür eder.

Kaynakça

  • Chopra V, Flanders SA, Saint S, Woller SC, O’Grady NP, Safdar N, et al. The michigan appropriateness guide for intravenous catheters (MAGIC): Results from a multispecialty panel using the RAND/UCLA appropriateness method. Ann Internal Med. 2015; 163(6Supplement): S1-40.
  • Lv L, Zhang J. The incidence and risk of infusion phlebitis with peripheral intravenous catheters: A meta-analysis. The Journal of Vascular Access. 2020; 21(3): 342-9.
  • Simin D, Milutinović D, Turkulov V. Brkić S. Incidence, severity and risk factors of peripheral intravenous cannula-induced complications: an observational prospective study. Journal of Clinical Nursing. 2019; 28(9-10): 1585-99.
  • İşeri A, Çınar B, Düzyaka DS, Sözeri E, Uğur E, Bay F, ve ark. Ulusal damar erişimi yönetimi rehberi. Hastane İnfeksiyonları Dergisi. 2019; 23(1): 1-54.
  • Mattox EA. Complications of peripheral venous access devices: Prevention, detection, and recovery strategies. Critical Care Nurse. 2017; 37(2): e1–e14.
  • Perez Fidalgo JA, Garcia Fabregat L, Cervantes A, Margulies A, Vidall C, Roila F. ESMO Guidelines working group. management of chemotherapy extravasation: ESMO EONS clinical practice guidelines. European Journal of Oncology Nursing. 2012; 16(5): 528-34.
  • Sarı D, Eşer İ, Akbıyık A. Phlebitis associated with peripheral intravenous catheters and nursing care. Journal of Human Sciences. 2016; 13(2): 2905-20.
  • Parreira P, Sousa LB, Marques IA, Santos-Costa P, Braga LM, Cruz A, et al. Double-chamber syringe versus classic syringes for peripheral intravenous drug administration and catheter flushing: a study protocol for a randomised controlled trial. Trials. 2020; 21(78): 1-10.
  • Infusion Therapy Standards of Practice [Internet]. Infusion Nurses Society. Journal of Infusion Nursing; 2016 [Updated: 2016 Feb; Cited 2022 Jan 20]. Available from: https://source.yiboshi.com/20170417/1492425631944540325.pdf.
  • Abe-Doi M, Murayama R, Komiyama C, Sanada H. Incidence, risk factors, and assessment of induration by ultrasonography after chemotherapy administration through a peripheral intravenous catheter. Jpn J Nurs Sci. 2020; 17: e12329.
  • Hwang EJ, Shin CI, Choi YH, Park CM. Frequency, outcome, and risk factors of contrast media extravasation in 142,651 intravenous contrast-enhanced CT scans. European Radiology. 2018; 28(12): 5368-75.
  • Australian Commission on Safety and Quality in Health Care [Internet]. Sydney; Management of Peripheral Intravenous Catheters Clinical Care Standard; 2021 [Updated: 2021 May; Cited 2022 Apr 28]. Available from: https://www.safetyandquality.gov.au/sites/default/files/202105/management_of_peripheral_intravenous_catheters_clinical_care_standard_-_accessible_pdf.pdf
  • Tosun B, Arslan BK, Özen N. Periferik venöz kateter kaynaklı flebit gelişme durumu ve hemşirelerin kanıta dayalı uygulamalara ilişkin bilgi düzeyleri: Nokta prevalans çalışması. Turkiye Klinikleri Hemşirelik Bilimleri. 2020; 12(1): 72-82.
  • Marsh N, Webster J, Ullman AJ, Mihala G, Cooke M, Chopra V, et al. Peripheral intravenous catheter non‐infectious complications in adults: A systematic review and meta‐analysis. Journal of Advanced Nursing. 2020; 76(12): 3346-62.
  • Berşe S, Tosun B, Tosun N. Periferik intravenöz katetere bağlı flebit oranının ve etkileyen faktörlerin değerlendirilmesi. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi. 2020; 13(3): 160-9.
  • Johann DA, Danski MTR, Vayego SA, Barbosa DA, Lind J. Risk factors for complications in peripheral intravenous catheters in adults: secondary analysis of a randomized controlled trial. Revista latino-americana de Enfermagem 2016; 24: e2833.
  • Onesti MG, Carella S, Fioramonti P, Scuderi N. Chemotherapy extravasation management: 21-year experience. Annals of Plastic Surgery. 2017; 79(5): 450-7.
  • Erdoğan BC, Baykara ZG. Periferik intravenöz kateter ilişkili flebit gelişimini önlemede hemşirelik bakımı. Gazi Sağlık Bilimleri Dergisi. 2020; 5(1): 30-6.
  • Kuş B, Büyükyılmaz F. Periferik intravenöz kateter uygulamalarında güncel kılavuz önerileri. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi. 2019; 8(3): 326-32.
  • Alexandrou E, Ray-Barruel G, Carr PJ. Use of short peripheral intravenous catheters: Characteristics, management, and outcomes worldwide. Journal of Hospital Medicine. 2018; 13(5): E1-E7.
  • Marsh N, Webster J, Larsen E, Cooke M, Mihala G, Rickard C. Observational study of peripheral intravenous catheter outcomes in adult hospitalized patients: A multivariable analysis of peripheral intravenous catheter failure. Journal of Hospital Medicine. 2018; 13(2): 83-9.
  • Blanco-Mavillard I, Parra-Garcia G, Fernandez-Fernandez I, Rodriguez-Calero MA, Personat-Labrador C, Castro-Sanchez E. Care of peripheral intravenous catheters in three hospitals in Spain: Mapping clinical outcomes and implementation of clinical practice guidelines. PloS One. 2020; 15(10): e0240086.
  • Arpa Y, Cengiz A. İntravenöz infüzyon tedavisine bağlı flebit ve tromboflebit gelişimini önleme ve tanılamada sağlık çalışanlarının bilgi düzeylerinin belirlenmesi. Hemşirelikte Eğitim ve Araştırma Dergisi. 2016; 13(1): 21-6.
  • Abadi P, Etemadi S, Abed Saeedi ZH. Investigating role of mechanical and chemical factors in the creation of peripheral vein in flammarion in hospitalization patients in hospital in Zahedan, Iran. Life Science Journal. 2013; 10(1): 379-83.
  • Braga L, Parreira P, Oliveira ASS, Mónico LSM, Sena CA, Henriques MA. Phlebitis and infiltration: Vascular trauma associated with the peripheral venous catheter. Rev Lat Am Enfermagem. 2018; 26(2): 1-8.
  • Avşar G, Gümüş K, Özer N, Aytekin A. Periferik venöz kateter uygulamaya ilişkin hemşirelerin durumlarının belirlenmesi. Gümüşhane Üniversitesi Sağlık Bilimleri Derg. 2013; 2(4): 499-507.
  • Aygün G, Karaşahin K, Dikmen Y, Yaşar H, Sıdan A, Midilli K, ve ark. Yoğun bakım ünitesinde periferik venöz kateterlerin infeksiyon yönünden değerlendirilmesi. Flora. 2004; 9(1): 43-6.
  • Abolfotouh MA, Salam M, Ala’a Bani-Mustafa DW, Balkhy HH. Prospective study of incidence and predictors of peripheral intravenous catheter-induced complications. Therapeutics and Clinical Risk Management. 2014; 10: 993.
  • Annisa F, Nurhaeni N, Wanda D. Warm water compress as an alternative for decreasing the degree of phlebitis. Comprehensive Child and Adolescent Nursing. 2017; 40(sup1): 107-13.
  • Gauttam VK, Vati DJ. A study to assess and compare the effectiveness of moist heat versus icepacks application in reducing the signs and symptoms of intravenous cannulation induced thrombophlebitis among patients admitted in çivil hospital of Dausa District, Rajasthan. IRA-International Journal of Applied Sciences. 2019; 3(3): 410-23.
  • Babu JM, Bansa P, Khan F, Husain M. A quasi-experimental study to assess the effectiveness of hot fomentation versus cold compress in reducing infiltration among patients undergoing IV infusion in a Selected Hospital of Delhi. Research and reviews. Journal of Surgery. 2016: 5(1): 24-30.
  • Rukhsana RJ, Tamang EL, Kochhar A. A quasi-experimental study to assess the effectiveness of cold application versus glycerin magnesium sulphate application in relieving phlebitis among patients receiving intravenous therapy in a selected hospital of Delhi. Research and reviews. Journal of Surgery. 2016; 5: 1-5.
  • Sharma A. A comparative study to assess the effectiveness of cold application, heparinoid application and magnesium-sulphate application on superficial thrombophlebitis among patients admitted in selected hospitals of Gujarat. International Journal of Nursing Education. 2016; 8(3): 118-21.
  • O’Grady NP, Alexander M, Burns LA, Dellinger P, Gardland J, Heard SO, et al. Guidelines for the prevention of intravascular catheter-related infections. Clinical Infectious Diseases. 2017; 39(4 Suppl 1): S1-34.
  • Cura ŞÜ, Atay S, Efil S. Hemşirelerin periferik venöz kateter uygulamasına ilişkin beceri durumlarının incelenmesi; gözlemsel bir çalışma. Ankara Sağlık Bilimleri Derg. 2019; 8(2): 30-8.
  • Gorski LA. The 2016 Infusion Therapy Standards of Practice. Home Healthcare Now. 2017; 35(1): 10-8.
Toplam 36 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Hemşirelik
Bölüm Araştırma Makaleleri
Yazarlar

Fatma Aksoy 0000-0002-5023-4468

Aysun Bayram 0000-0003-2038-6265

Şule Bıyık Bayram 0000-0002-9842-1588

Yayımlanma Tarihi 21 Eylül 2023
Gönderilme Tarihi 25 Kasım 2022
Yayımlandığı Sayı Yıl 2023 Cilt: 13 Sayı: 3

Kaynak Göster

Vancouver Aksoy F, Bayram A, Bıyık Bayram Ş. Periferik İntravenöz Kateterizasyon Komplikasyonlarında Hemşirelik Girişimleri ve Hasta Deneyimleri. SABD. 2023;13(3):395-40.