Journal of infusion nursing : the official publication of the Infusion Nurses Society
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Central line-associated bloodstream infections (CLABSIs) account for one-third of all hospital-acquired infections and can cost the health care system between $21,000 and $100,000 per infection. A dedicated vascular access team (VAT) can help develop, implement, and standardize policies and procedures for central line usage that address insertion, maintenance, and removal as well as educate nursing staff and physicians. ⋯ Central line utilization decreased by 45.2%, and CLABSI incidence decreased by 90%. The results of the study demonstrated that a reduced utilization of central lines minimized the risk of patients developing a CLABSI.
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Comparative Study
Improving Aseptic Technique During the Treatment of Pediatric Septic Shock: A Comparison of 2 Rapid Fluid Delivery Methods.
Rapid fluid resuscitation is used to treat pediatric septic shock. However, achieving fluid delivery goals while maintaining aseptic technique can be challenging. ⋯ PPT was associated with multiple aseptic technique violations related to contamination of the syringe barrel. This study confirms the risk of PPT-associated syringe contamination and suggests that this risk could be mitigated with the use of a protected syringe system, such as LifeFlow.
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Randomized Controlled Trial
Effects of Thermomechanical Stimulation During Intravenous Catheter Insertion in Adults: A Prospective Randomized Study.
This was an open-label, randomized clinical trial comparing the effects of thermomechanical stimulation (Buzzy) versus no intervention in 105 adults undergoing intravenous (IV) catheter insertion before elective orthopedic surgical procedures. A visual analog scale was used to measure pain; satisfaction questionnaires were administered after IV catheter insertion. ⋯ Subjects who reported higher preprocedure anxiety benefited most from the test intervention. It was determined that the application of cold and vibration is not universally effective for pain prevention during IV catheter insertion or for improvement in patient satisfaction in preoperative care.
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Syringe infusion pumps (SIPs) led to major advances in infusion therapy and were gradually applied to the transfusion of packed red blood cells (RBCs), raising questions about possible cell damage. The objectives of this study were to determine levels of hematocrit (%), total hemoglobin (g/dL), free hemoglobin (g/dL), lactate dehydrogenase (units/L), potassium (mmol/L), the degree of hemolysis (%) of RBCs infused by an SIP, and to investigate the influence of the infusion rate. ⋯ The results showed total hemoglobin reduction (P = .003), and increased free hemoglobin and hemolysis (P <.001) were identified. The conclusion reached was that RBCs presented changes in free hemoglobin and degree of hemolysis.
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The Centers for Disease Control and Prevention estimates that more than 300 000 new cases of Lyme disease occur each year in the United States and that 10% to 20% of these patients will remain symptomatic despite receiving appropriate antibiotic therapy. Many elements of the disease are poorly understood and have generated considerable controversy. This paper discusses the medical controversies related to posttreatment manifestations and their potential impact on infusion nurses.