Aim: To test the feasibility of a study protocol that compared the efficacy of neutral- and negative-pressure needleless connectors (NCs).
Design: A single-centre, parallel-group, pilot randomised control trial.
Methods: Our study compared neutral-(intervention) and negative-pressure (control) NCs among adult patients in an Australian hospital. The primary feasibility outcome was measured against predetermined criteria (e.g. eligibility, attrition). The primary efficacy outcome was all-cause peripheral intravenous catheter failure, analysed as time-to-event data.
Results: In total, 201 (100 control; 101 intervention) participants were enrolled between March 2020 and September 2020. All feasibility criteria were met except eligibility, which was lower (78%) than the 90% criterion. All-cause peripheral intravenous catheter failure was significantly higher in the intervention group (39%) compared to control (19%).
Conclusion: With minor modifications to participant screening for eligibility, this randomised control trial is feasible for a large multicentre randomised control trial. The neutral NC was associated with an increased risk of peripheral intravenous catheter failure.
Implications For The Profession And/or Patient Care: There are several NC designs available, often identified by their mechanism of pressure (positive, negative and neutral). However, NCs can contribute to peripheral intravenous catheter failure. This is the first randomised controlled trial to compare neutral and negative NC designs. Negative pressure NCs had lower PIVC failure compared to neutral NCs, however the results might not be generalisable to other brands or treatment settings. Further high-quality research is needed to explore NC design.
Reporting Method: Study methods and results reported in adherence to the CONSORT Statement.
Patient Or Public Contribution: No patient or public contribution.
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http://dx.doi.org/10.1111/jocn.16852 | DOI Listing |
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.
View Article and Find Full Text PDFJ Infus Nurs
January 2025
Author Affiliations: Escola Paulista de Enfermagem, Universidade Federal de São Paulo (EPE-UNIFESP), São Paulo, Brazil (RN Doll); Escola Paulista de Enfermagem, Universidade Federal de São Paulo (EPE-UNIFESP), São Paulo, Brazil (RN Aprile); Escola Paulista de Enfermagem, Universidade Federal de São Paulo (EPE-UNIFESP), São Paulo, Brazil (RN Gonçalves); Programa de Pós-graduação em Ciências Farmacêuticas, Universidade Estadual de Feira de Santana (UEFS), Bahia, Brazil (Prof da Silva); Escola Paulista de Enfermagem, Universidade Federal de São Paulo (EPE-UNIFESP), São Paulo, Brazil (Prof Kusahara); Escola Paulista de Enfermagem, Universidade Federal de São Paulo (EPE-UNIFESP), São Paulo, Brazil (Prof Lopes).
The aims of this study were to develop a questionnaire on peripheral intravenous catheter (PIVC) maintenance, evaluate its content validity, and assess factors influencing the level of knowledge of nursing professionals regarding best practices.The study was conducted in 3 stages: (1) development of a questionnaire on PIVC maintenance; (2) content validity assessment by experts with assessment of comprehensiveness, relevance, and clarity; and (3) application of the questionnaire to 1493 nursing professionals. Relationships between personal characteristics and knowledge levels were evaluated.
View Article and Find Full Text PDFJ Infus Nurs
January 2025
Author Affiliations: Faculty of Nursing, Department of Nursing, Josai International University, Chiba, Japan (Mss Kitada and Tateno; Drs Ninomiya and Kabashim); Faculty of Pharmaceutical Sciences, Department of Medical Pharmacy, Josai International University, Chiba, Japan (Dr Yamamura); Behavioral Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan (Dr Hori).
Age-related physiological changes affect various aspects of peripheral intravenous catheter (PIVC) cannulation. However, the characteristics of PIVCs, especially in older patients, have been poorly investigated. In the current cross-sectional observational study, PIVC sizes, PIVC sites, the number of attempts until successful insertion, and the degree of venodilation upon insertion among hospital inpatients aged ≥65 years were investigated, along with measurements of the vessel diameter and depth using ultrasound.
View Article and Find Full Text PDFGuillain-Barré Syndrome (GBS) is an acute inflammatory polyradiculoneuropathy that affects the peripheral nervous system, predominantly impairing motor function. Pain, both somatic and neuropathic, is reported in 89% of cases and is refractory to first-line analgesics in most of these. We present the case of a 75-year-old woman with an acute presentation of areflexic flaccid tetraparesis compatible with GBS.
View Article and Find Full Text PDFA A Pract
January 2025
Division of Anaesthesiology and Perioperative Medicine, Department of Pain Medicine, Singapore General Hospital, Singapore.
Brugada syndrome is a rare condition that increases the risk of life-threatening arrhythmias. Although there are existing anesthesia recommendations for patients with Brugada syndrome, guidance on pain management is limited. We present a novel approach to pain management in these patients, illustrated by the case of a young woman with Brugada syndrome who underwent ropivacaine peripheral nerve infusion and intravenous ketamine infusion for acute-on-chronic left upper limb pain.
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