BACKGROUND Central venous catheters (CVCs) have been an effective access for chemotherapy instead of peripherally intravenous catheters. There were limited studies on the choices and effects of different types of CVCs for chemotherapy. The aim of this study was to compare the complications, cost, and patients' quality of life and satisfaction of three commonly used CVCs for chemotherapy, such as implanted venous port, peripherally inserted central catheters (PICCs), and external non-tunneled central venous catheters (NTCs). METHODS A double-center prospective cohort study was carried out from March 2014 to December 2016. Catheterization situation, complications, catheter maintenance, cost, and patients' quality of life and satisfaction were recorded, investigated, and analyzed. Forty-five ports, 60 PICCs and 40 NTCs were included. All the CVCs were followed up to catheter removal. RESULTS There was no statistical difference in catheterization success rates between port and PICC. NTC had less success rate by one puncture compared with port. Ports had fewer complications compared with PICCs and NTCs. The complication rates of ports, PICCs and NTCs were 2.2%, 40%, and 27.5%, respectively. If the chemotherapy process was <12 months, NTCs cost least, and the cost of port was much higher than PICC and NTC. When the duration time was longer than 12 months, the cost of port had no difference with the cost of PICC. Quality of life and patients' satisfaction of port group were significantly higher than the other two groups. CONCLUSION Although port catheterization costs more and needs professional medical staff and strict operational conditions, ports have fewer complications and higher quality of life and patients' satisfaction than PICCs and NTCs. Therefore, not following consideration of the economic factor, we recommend port as a safe and an effective chemotherapy access for cancer patients, especially for whom needing long chemotherapy process.

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Comparison of three types of central venous catheters in patients with malignant tumor receiving chemotherapy

Background: Improving patient safety, reducing and preventing central line –related infection especially in the intensive care unit are now a priority for hospitals. Therefore; nurses play an integral role in preventing infections. Aim of the study is to develop guidelines for prevention of central line infection and examine the effect of implementation of those guidelines on the nurses' knowledge and practice. Setting: The present study was conducted in intensive care unit of New Surgical Hospital affiliated to Zagazig University Hospitals. Sample: The study sample was included 40 nurses who are working in the above mentioned setting. Tools: Two tools were used for data collection which includes questionnaire sheet and observational checklist. Results: The study results revealed that prior to guidelines implementation; majority of nurses had unsatisfactory knowledge score and practice. In post guidelines, the findings pointed out to significant improvement. There was a statistically significant correlation between knowledge and practice score. Conclusion: Nurses' knowledge and practice improve after implementation of the guidelines for prevention of central line infection. Recommendations: Provision of continuous education and guidelines for prevention of central line infection, all needed equipment and supplies and further studies to examine the impact of guideline on patients' outcomes are required.

https://znj.journals.ekb.eg/article_39215_8b4de895bf29946a34872281e5b70f8f.pdf

Clinical Practice Guidelines for Prevention of Central Line Infection

AimThe aim of this study is to compare the complication rates of three vascular access devices in patients with solid tumours having infusion chemotherapy.Materials and MethodsAn observational study of 58 central venous catheter (CVC) lines inserted in 55 patients with solid tumours requiring infusional chemotherapy was performed. The study was conducted between January 2011 and August 2013, looking at complication and infection rates as primary outcomes. Data were recorded from patients with 19 tunnelled cuffed silicone catheters, nine with peripherally inserted central catheters (PICCs) and 30 central venous ports.ResultsThe two CVC groups (ports and non-ports) matched equally in terms of tumour site; all patients with solid tumours were included, haematology patients were excluded and chemotherapy regimens were comparable. Thirteen out of 28 non- ports had complications compared with one out of 30 central venous ports. Ten out of 19 tunnelled catheters had complications including three displacements an...

A comparison of infections and complications in central venous catheters in adults with solid tumours.


 
 What we know about the topic: Recommendations for the use of vascular access care bundles to reduce infection are followed for different devices. The risk of arterial catheter-related infection is comparable with short-term, non-cuffed central venous catheters. There are practice concerns for clinicians inserting and caring for peripheral arterial catheters.
 What this paper adds: The selected studies had a theme of decreased infection after using bundled strategies for all devices. Few studies addressed use of bundles for care of peripheral arterial catheters. High quality research should be performed about using care bundles for insertion and care of arterial catheters.
 
 
 
 
 
 A scoping review of the literature was performed.
 
 
 
 To find information on the use of care bundles for care of arterial, central, and peripherally inserted venous catheters.
 
 
 
 Data was extracted by 2 independent researchers using standardized methodology
 
 
 
 Results of 84 studies included 2 (2.4%) randomized controlled trials, 38 (45.2%) observational studies, 29 (34.5%) quality projects, and 15 (17.9%) reviews. Populations had more adults than pediatric patients. All studies had the most prominent theme of decreased infection in all devices after using bundle strategies.
 
 
 
 The mapping of available evidence strongly supports the use of care bundles to reduce infection in the care of all intravascular devices. However, deficiencies regarding practice concerns about insertion and care of arterial catheters highlight areas for future research with the aim to eliminate the gap in the evidence of studies of care bundles for peripheral arterial catheters.
 


Care Bundles and Peripheral Arterial Catheters: A Scoping Review

Catheter-related bloodstream infections are associated with significantly increased morbidity, mortality, and expenditures. Such infections are a serious threat to patient safety in the intensive care unit. This review describes the latest protocols related to preventing and treating central venous catheter-associated bloodstream infections in critically ill patients. According to 2011 Center for Disease Control (CDC) guidelines and central line care bundles by the institute for healthcare improvement (IHI), prevention measures for catheter-related bloodstream infections include the following: hand hygiene, maximal barrier precautions insertion, chlorhexidine skin antisepsis, optimal catheter site selection, proper catheter maintenance, insertion site care, and daily review of line necessity, with prompt removal of unnecessary lines. These are important and effective infection prevention measures. Guidelines and care bundles also recommend organizing care modules based on unit characteristics; integrating resources and empirical measures; education and training to promote comprehensive implementation; and auditing and monitoring to ensure staff continue to follow procedures. Effectively preventing central venous catheter-related bloodstream infections can enhance care quality and move healthcare closer to achieving the goal of zero tolerance.

[Prevention and nursing care of central line-associated bloodstream infections in critically ill patients].

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[Prevention and nursing care of central line-associated bloodstream infections in critically ill patients].