Peripherally Inserted Central Venous Catheter: an Alternative for Improving the Quality of Nursing Care
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Release | : 2017 |
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Introduction: Evidence suggests high rates of complications related to the peripheral venous catheter (PVC). Among causes is the administration of irritant/vesicant medicine, with pH u2264 5 or u2265 9 and osmolarity u2265 900 mOsm/L(1-2) . These risk factors are indications for using peripherally inserted central venous catheters (PICC)(3-4). Therefore, their use may be an alternative for improving the outcome of nursing care. However, safely using PICC requires the acquisition of knowledge based on scientific evidence, because care differs from that usually provided to patients with PVC(4). Objective: Analyze the cumulative incidence of complications in Portuguese patients with PICC or PVC after implementing an educational intervention on care with PICC. Method: A theoretical and practical educational intervention with nurses of a service of medicine of Portugal, on care for patients in the insertion, maintenance and monitoring of the PICC. A cohort pilot study was held during 40 consecutive days, in 2016. Patients included were adults: nine patients with PICC and 36 with PVC. Descriptive statistical analysis was performed. Results: Complication in patients with PICC: obstruction (22.2%); PVC: Phlebitis (22.2%), infiltration (38.8%), obstruction (27.7%), accidental removal of the PVC (47.2%), fluid leakage on insertion (36.1%) and pain at the site of insertion (5.5%). Discussion & Conclusion: Permanent education is essential to improve nurses' knowledge of PICC care, and is a strategy to achieve higher levels of qualification and the transformation of practices (5). PICC showed a lower incidence of complications when compared to the PVC, becoming a favorable alternative to improve the quality of nursing care to patients who have a medical indication for PICC. Ensuring the criteria of selection of a venous catheter is essential in order to reduce complications, improve the results of nursing care and promote the patients' well-being (3-4).