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Five-year sustainability of a de-implementation strategy to reduce inappropriate use of catheters: a multicentre, mixed-methods study.

EClinicalMedicine

September 2024

Amsterdam UMC, University of Amsterdam, Department of Internal Medicine-Infectious Diseases, Amsterdam Institute for Infection and Immunity, Amsterdam Public Health, the Netherlands.

Background: The use of peripheral intravenous catheters (PIVCs) contributes to healthcare-associated infections. In 2017, we implemented a multifaceted de-implementation strategy that successfully reduced the inappropriate use of catheters in seven hospitals in the Netherlands (RICAT-1 study). Five years later, we investigated the sustainability of this strategy and the contributing factors.

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Transcatheter mitral valve replacement (TMVR) may emerge as a surgical alternative for high-risk patients with severe mitral annular calcification (MAC), yet several questions remain to be addressed. We present the case of a 67-year-old high-risk female patient with severe MAC (MAC score = 8) and mitral stenosis (effective orifice area = 121.3 mm).

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Methods: Between 2004 and 2023, a retrospective examination was conducted on kidney transplant recipients who underwent removal of ureteral catheters through retrograde cystoscopy at our facility or referred from external centres. The collected data encompassed patient demographics, pre- and posttransplant maximum urinary flow rate, specifics of stenosis, surgical interventions and outcomes from a 1-year follow-up.

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Whey Protein-Based Hydrogel Microspheres for Endovascular Embolization.

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January 2025

Department of Radiology, University of Minnesota, Minneapolis, Minnesota 55455, United States.

Transarterial embolization (TAE) is an image-guided, minimally invasive procedure for treating various clinical conditions by delivering embolic agents to occlude diseased arteries. Conventional embolic agents focus on vessel occlusion but can cause unintended long-term inflammation and ischemia in healthy tissues. Next-generation embolic agents must exhibit biocompatibility, biodegradability, and effective drug delivery, yet some degradable microspheres degrade too quickly, leading to the potential migration of fragments into distal blood vessels causing off-target embolization.

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Medical device-related pressure injuries (MDRPIs) pose a significant risk in the home health environment, where patients may lack continuous professional oversight. Devices commonly used in the home environment with the potential to cause a MDRPI include but are not limited to nasogastric tubes, feeding tubes, nasal cannulas, nasal cannula prongs, airway pressure masks, indwelling urinary catheters, sequential compression devices, dressings, bandages, and tracheostomies. When a medical device is used for an extended period, it can lead to unrelieved pressure or edema, cause friction and/or shearing that impairs sensation, reduces circulation, and alters the microclimate.

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