Calidad de la atención en el cateterismo venoso periférico: una revisión sistemática exploratoria

Costa, Saulo Pereira da; Silveira, Rodrigo Euripedes da; Monteiro, Damiana Aparecida Trindade; Contim, Divanice; Toffano, Silmara Elaine Malaguti

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Revista Brasileira de Enfermagem

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Brasil

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Sumário

REVIEW • Rev. Bras. Enferm. 76 (6) • 2023 • https://doi.org/10.1590/0034-7167-2022-0578 copiar

Calidad de la atención en el cateterismo venoso periférico: una revisión sistemática exploratoria

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

Mapear el estado actual de los parámetros y herramientas para evaluar la calidad de la atención relacionada con el uso de catéteres venosos periféricos en adultos.

Métodos:

Revisión sistemática exploratoria, realizada en 2022 en las bases de datos MEDLINE, LILACS, CINAHL y SCOPUS y con un límite temporal de publicación de 2013 a 2022.

Resultados:

La muestra fue de 15 artículos, resumidos en las siguientes categorías: Indicación, documentación y registro, evaluación de la cobertura, conexión, estabilización y signos y síntomas inherentes al catéter. El uso de un instrumento completo, con los dominios observados en esta revisión, puede tener un impacto positivo en una práctica clínica más eficaz y segura.

Conclusiones:

Esta revisión ha mapeado las evidencias sobre la inserción y el mantenimiento de catéteres venosos periféricos que pueden mejorarse con una buena formación práctica y calidad del personal, en relación con el uso de herramientas, materiales e instrumentos para evaluar la atención.

Descriptores:
Cateterismo Periférico; Encuestas y Cuestionarios; Evaluación en Salud; Calidad de la Atención de Salud; Revisión

SOURCE	SYNTAX
BVS/LILACS	(“Avaliação em Enfermagem” OR “Nursing Assessment” OR “Evaluación em Enfermería” OR “Avaliação em Saúde” OR “Health Evaluation” OR “Evaluación en Salud”) AND (“Cateterismo Periférico” OR “Cateterismo Venoso Periférico” OR “Catheterization, Peripheral” OR “Peripheral intravenous cateter”) AND “Adult” OR “aged”
SCOPUS	(TITLE-ABS-KEY ((nursing AND assessment) OR (health AND evaluation)) AND TITLE-ABS-KEY ((catheterization, AND peripheral) OR (peripheral AND intravenous AND cateter)) AND TITLE-ABS-KEY ((adult)) AND TITLE-ABS-KEY ((quality) OR (health AND care)))
CINAHL	((nursing assessment OR health evaluation)) AND ((catheterization, peripheral OR peripheral intravenous cateter)) AND (adult OR aged ))
MEDLINE via PubMed	((Nursing Assessment OR Health Evaluation)) AND (Catheterization, Peripheral OR Peripheral intravenous cateter) AND (Quality of Health Care OR Quality OR Health Care) AND (adult OR aged)

Author/Title	Year Country	Design/Sample	Objective/ Interventions	Outcomes	Level of Evidence
Carr, Rippey, Cooke(²⁰20 Carr PJ, Rippey JCR, Cooke ML, Trevenen ML, Higgins NS, Foale AS, et al. Factors associated with peripheral intravenous cannulation first time insertion success in the emergency department: a multicentre prospective cohort analysis of patient, clinician and product characteristics. BMJ Open 2019;9:e022278. https://doi.org/10.1136/bmjopen-2018-022278 https://doi.org/10.1136/bmjopen-2018-022... ) “Factors associated with peripheral intravenous cannulation first time insertion success in the emergency department”.	2019 Australia	Prospective observational 879 patients (n=1,201 PVC)	To identify the incidence of factors associated with peripheral intravenous infusion and the success rate of first versus two or more punctures.	Incidence of first puncture success rate = 645/879. Success related to age and palpability of the patient’s vein, as well as practitioner’s confidence and experience.	3.e
Sweeny et al.(²¹21 Sweeny A, Archer-Jones A, Watkins S, Johnson L, Gunter A, Rickard C. The experience of patients at high risk of difficult peripheral intravenous cannulation: an Australian prospective observational study, Australas. Emerg Care. 2021;25(2):140-6. https://doi.org/10.1016/j.auec.2021.07.003 https://doi.org/10.1016/j.auec.2021.07.0... ) “The experience of patients at high risk of difficult peripheral intravenous cannulation: An Australian prospective observational study”.	2022 Australia	Prospective observational n=1,084	To identify patients with difficult peripheral intravenous cannulation (DPIVC)	Patient characteristics (absence of visible or palpable vein, history of difficult PVC) type of PVC (larger caliber), site (hand and wrist) were pointed out as factors.	3.e
Marsh et al.(²²22 Marsh N, Webster J, Ullman AJ, Mihala G, Cooke M, Chopra V, et al. Peripheral intravenous catheter non-infectious complications in adults: a systematic review and meta-analysis. J Adv Nurs. 2020;76(12):3346-62. https://doi.org/10.1111/jan.14565 https://doi.org/10.1111/jan.14565... ) “Peripheral intravenous catheter non-infectious complications in adults: A systematic review and meta-analysis”.	2020 Australia	Systematic review with 103 studies (n= 96,777 PVC)	To point out main peripheral complications related to PVC use and where they were inserted.	Incidence of phlebitis (23.8%) and infiltration (13.7%) being significantly higher when catheters were inserted in the emergency department.	1.b
Mihala et al.(²³23 Mihala G, Ray-Barruel G, Chopra V, Webster JBA, Wallis M, Marsh N, et al. Phlebitis signs and symptoms with peripheral intravenous catheters. J Infus Nurs. 2018;41(4):260-3. https://doi.org/10.1097/NAN.0000000000000288 https://doi.org/10.1097/NAN.000000000000... ) “Phlebitis signs and symptoms with peripheral intravenous catheters”.	2018 Australia	Descriptive observational n=3,283	To calculate incidence of signs and symptoms for diagnosis of phlebitis and their correlations.	Considerably low incidence and only correlations observed were heat x stiffness, heat x swelling and heat x erythema.	4.a
Marsh et al.(²⁴24 Marsh N, Webster J, Mihala G, Rickard CM. Devices and dressings to secure peripheral venous catheters: a Cochrane systematic review and meta-analysis. Int J Nurs Stud. 2017;67:12-19. https://doi.org/10.1016/j.ijnurstu.2016.11.007 https://doi.org/10.1016/j.ijnurstu.2016.... ) “Devices and dressings to secure peripheral venous catheters: A Cochrane systematic review and meta-analysis”.	2017 Australia	Systematic review with meta-analysis of 6 studies (n=1,539)	To evaluate the effects of fixation devices on the incidence of catheter loss.	Less PVC detachment with transparent dressing compared to gauze.	1.a
Schmutz et al.(²⁵25 Schmutz A, Menz L, Schumann S, Heinrich S. Dislodgement forces and cost effectiveness of dressings and securement for peripheral intravenous catheters: a randomized controlled trial. J Clin Med. 2020;9(10):E3192. https://doi.org/10.3390/jcm9103192 https://doi.org/10.3390/jcm9103192... ) “Dislodgement forces and cost effectiveness of dressings and securement for peripheral intravenous catheters: A randomized controlled trial”.	2020 Germany	Randomized controlled trial n= 209	Force required to remove a PVC versus four dressing and fixation methods.	Sterile absorbent dressing covered by two incisive polyester wool elastics had higher strength and better cost-effectiveness compared to the other techniques.	1.c
Rickard et al.(²⁶26 Rickard CM, Marsh N, Webster J, Runnegar N, Larsen E, McGrail MR, et al. Dressings and securements for the prevention of peripheral intravenous catheter failure in adults (SAVE): a pragmatic, randomised controlled, superiority trial. Lancet. 2018;392(10145):419-30. https://doi.org/10.1016/S0140-6736(18)31380-1 https://doi.org/10.1016/S0140-6736(18)31... ) “Dressings and securements for the prevention of peripheral intravenous catheter failure in adults (SAVE):a pragmatic, randomized controlled, trial”.	2018 Australia	Randomized controlled trial n= 1,807	Effectiveness and costs of three types of standard borderless polyurethane dressing.	No significant results were observed. These methods are associated with loss of PVCs and low durability.	1.c
Corley et al.(²⁷27 Corley A, Marsh N, Ullman AJ, Rickard CM. Peripheral intravenous catheter securement: an integrative review of contemporary literature around medical adhesive tapes and supplementary securement products. J Clin Nurs. 2022;32(9-10):1841-57. https://doi.org/10.1111/jocn.16237 https://doi.org/10.1111/jocn.16237... ) “Peripheral intravenous catheter securement: An integrative review of contemporary literature around medical adhesive tapes and supplementary securement products”.	2022 Australia	Integrative review with 19 studies n=43,683 PVC	Synthesize the evidence related to medical adhesive tapes for PVCs.	The quality assessment identified high risk of bias or confounding factors. The authors concluded that the evidence is limited.	4.b
Keogh et al.(²⁸28 Keogh S, Shelverton C, Flynn J, Mihala G, Mathew S, Davies KM, et al. Implementation and evaluation of short peripheral intravenous catheter flushing guidelines: a stepped wedge cluster randomised trial. BMC Med. 2020;18:252. https://doi.org/10.1186/s12916-020-01728-1 https://doi.org/10.1186/s12916-020-01728... ) “Implementation and evaluation of short peripheral intravenous catheter flushing guidelines: a stepped wedge cluster randomized trial”.	2020 Australia	Randomized controlled trial n= 619	Evaluated the impact of a multifaceted intervention for PVC maintenance.	lushing with 0.9% NaCL administered via an already prepared syringe with ready-to-use system showed a difference in risk (-8%, 95% CI -14 to -1, p = 0.032) compared to the control group with standard care.	1.d
Marsh et al.(²⁹29 Marsh N, Webster J, Flynn J, Mihala G, Hewer B, Fraser J, et al. Securement methods for peripheral venous catheters to prevent failure: a randomised controlled pilot trial. J Vasc Access. 2015;16(3):237-44. https://doi.org/10.5301/jva.5000348 https://doi.org/10.5301/jva.5000348... ) “Securement methods for peripheral venous catheters to prevent failure: A randomized controlled pilot trial”.	2015 Australia	Randomized controlled trial n=89	Evaluating the effectiveness of four safety methods to prevent PVC-related failures	Catheter failure was lowest in the tissue adhesive group (14%) and highest in the control group (38%).	1.c
Marsh et al.(³⁰30 Marsh N, Larsen E, Hewer B, Monteagle E, Ware RS, Schults J, et al. 'How many audits do you really need?': learnings from 5-years of peripheral intravenous catheter audits. Infect Dis Health. 2021;26(3):182-8. https://doi.org/10.1016/j.idh.2021.03.001 https://doi.org/10.1016/j.idh.2021.03.00... ) “How many audits do you really need?: Learnings from 5-years of peripheral intravenous catheter audits”.	2021 Australia	Prospective observational n=2,274 PVC	Determine the optimal number of PVC patients for clinical audits.	Authors defined that optimal values should be between 100 and 250 PVC per audit round, depending on the prevalence of complication.	3.e
Dutra et al.(³¹31 Dutra GO, Moraes MCS, Lima TC, Alves DFS, Silva VA, Gasparino RC. Prevention of events with vascular catheters: validation of an instrument. Rev Enferm UFPE. 2021;15:e246201. https://doi.org/10.5205/1981-8963.2021.246201 https://doi.org/10.5205/1981-8963.2021.2... ) “Prevention of events with vascular catheters: Validation of an instrument”.	2021 Brazil	Methodological study n=50	To validate an instrument that identifies factors that hinder PVC insertion and maintenance.	Instrument proved to be valid (high Content Index) and reliable (through Interobserver reliability using Kappa coefficient).	4.c
Yagnik, Graves, Thong(³²32 Yagnik L, Graves A, Thong K. Plastic in patient study: prospective audit of adherence to peripheral intravenous cannula monitoring and documentation guidelines, with the aim of reducing future rates of intravenous cannula-related complications. Am J Infect Control. 2017;45(1):34-38. https://doi.org/10.1016/j.ajic.2016.09.008 https://doi.org/10.1016/j.ajic.2016.09.0... ). “Plastic in patient study: Prospective audit of adherence to peripheral intravenous cannula monitoring and documentation guidelines, with the aim of reducing future rates of intravenous cannula-related complications”.	2017 Australia	Prospective observational n=102	To improve compliance of PVC documentation and monitoring through three “The plastic in patient - PIP” interventions.	Documentation improved in the post-intervention group (36.4 x 50%, p = 0.025). Early identification for non-indication of PVC and a trend towards a reduction in PVC-related phlebitis also had positive results post-intervention.	3.c
Webster et al.(³³33 Webster J, Osborne S, Rickard CM, Marsh N. Clinically-indicated replacement versus routine replacement of peripheral venous catheters. Cochrane Database Syst Rev[Internet]. 2019 [cited 2022 Apr 21];1(1):CD007798. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6353131/pdf/CD007798.pdf https://www.ncbi.nlm.nih.gov/pmc/article... ) “Clinically indicated replacement versus routine replacement of peripheral venous catheters”.	2019 Australia	Systematic review with meta-analysis of 9 studies (n = 7,412)	To evaluate the effects of PVC removal when clinically indicated versus routine catheter removal.	There is no clear difference in the rates of catheter-related infection, phlebitis and pain in the two groups. There is moderate-certainty evidence that catheter infiltration and blockage are lower when access is changed routinely. With moderate certainty evidence, there was a reduction in device-related costs when clinically indicated.	1.a
Ray-Barruel et al.(³⁴34 Ray-Barruel G, Cooke M, Chopra V, Mitchell M, Rickard CM. The I-DECIDED clinical decision-making tool for peripheral intravenous catheter assessment and safe removal: a clinimetric evaluation. BMJ Open. 2020;10:e035239. https://doi.org/10.1136/bmjopen-2019-035239 https://doi.org/10.1136/bmjopen-2019-035... ) “The I-DECIDED clinical decision-making tool for peripheral intravenous catheter assessment and safe removal: a clinimetric evaluation”.	2020 Australia	Methodological study n=68	To validate an 8-step tool for device assessment and decision making.	“I-DECIDED” tool demonstrated strong content validity, with high reliability and replicability for advising PVC-related decision making and assistance.	4.c

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[1] Corresponding author: Saulo Pereira da Costa, E-mail: saulo.costa@uftm.edu.br