Journal of intravenous nursing : the official publication of the Intravenous Nurses Society
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When questions arose in the spring of 1990 concerning central venous catheter infections at a 414-bed, midwestern hospital, it was found that no hospital-wide prospective study of this problem had ever been completed. A descriptive, prospective study was conducted over 6 months, from October 1990 to April 1991, to determine the rate of infection associated with short-term central venous catheters at the study hospital. Additional research questions sought to examine the influence of certain risk factors on central venous catheter infection rates. ⋯ Correlation of infection with risk factors was not possible because of the small number of infections. The clinical line infection rates found in this study compare favorably with other rates reported in the literature. Although the presence of any exceptional problem with central line infections at the hospital was not supported by this study, the number of lines placed during the study emphasizes the importance of high-quality central venous catheter placement and maintenance technique throughout the institution.
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Difficulty with removing peripherally inserted central catheters is being encountered with increasing frequency. The most common cause of this phenomenon is venous spasm. Although gentle traction may overcome mild spasm, aggressive pulling is contraindicated. Methods and maneuvers to alleviate spasm are discussed, the simplest of which is to attempt catheter removal again after a short (20 to 30 minutes) or intermediate (12 to 24 hours) length of time, at which time spasm may have spontaneously abated.