The practical integration of a hybrid model of ultrasound-guided peripheral venous access in a large apheresis center.
apheresis procedures
peripheral IV access
ultrasound-guided peripheral IV access
vascular access
Journal
Journal of clinical apheresis
ISSN: 1098-1101
Titre abrégé: J Clin Apher
Pays: United States
ID NLM: 8216305
Informations de publication
Date de publication:
Aug 2020
Aug 2020
Historique:
received:
06
11
2019
revised:
14
05
2020
accepted:
24
05
2020
pubmed:
3
7
2020
medline:
3
8
2021
entrez:
3
7
2020
Statut:
ppublish
Résumé
Apheresis treatments require adequate venous access using peripheral intravenous (PIV) catheterization or central venous catheters (CVC). Ultrasound-guided PIV (USGPIV) can be used to decrease the need of CVC insertions for apheresis procedures. A hybrid model of USGPIV and standard of care (SOC) for PIV access was developed. Nurses performed USGPIV on all patients considered for PIV access if felt SOC PIV access was not possible. Information was collected regarding nurses' confidence with access, number of attempts required, site of access, complications, and need for CVC. In all, 226 PIV access attempts were made during a 2-month period. All apheresis procedure types were represented. A total 65% were accessed by SOC and 35% by USGPIV. USGPIV was successful on first try on 90% draw/inlet access and 87% successful on first try on return access. Access above the antecubital fossa was required in 31% of USGPIV for draw/inlet veins, and 22% of return veins. Nurses' confidence with accessing PIV was increased by USGPIV, based on 7-point Likert scale assessments. During the recording period, 2/226 (0.9%) apheresis procedures required a CVC. In a separate cohort of only hematopoietic progenitor cell collections, CVC insertion was required in 44/238 (18.5%) patients, in 7 months prior to adoption of USGPIV and 5/152 (3.3%) patients in 7 months following adoption of USGPIV. A hybrid model of using SOC and USGPIV for PIV access for apheresis procedures resulted in decreased need for CVC access, high levels of successful initial access attempts, and increased nursing confidence in PIV access.
Sections du résumé
BACKGROUND
BACKGROUND
Apheresis treatments require adequate venous access using peripheral intravenous (PIV) catheterization or central venous catheters (CVC). Ultrasound-guided PIV (USGPIV) can be used to decrease the need of CVC insertions for apheresis procedures.
METHOD
METHODS
A hybrid model of USGPIV and standard of care (SOC) for PIV access was developed. Nurses performed USGPIV on all patients considered for PIV access if felt SOC PIV access was not possible. Information was collected regarding nurses' confidence with access, number of attempts required, site of access, complications, and need for CVC.
RESULTS
RESULTS
In all, 226 PIV access attempts were made during a 2-month period. All apheresis procedure types were represented. A total 65% were accessed by SOC and 35% by USGPIV. USGPIV was successful on first try on 90% draw/inlet access and 87% successful on first try on return access. Access above the antecubital fossa was required in 31% of USGPIV for draw/inlet veins, and 22% of return veins. Nurses' confidence with accessing PIV was increased by USGPIV, based on 7-point Likert scale assessments. During the recording period, 2/226 (0.9%) apheresis procedures required a CVC. In a separate cohort of only hematopoietic progenitor cell collections, CVC insertion was required in 44/238 (18.5%) patients, in 7 months prior to adoption of USGPIV and 5/152 (3.3%) patients in 7 months following adoption of USGPIV.
CONCLUSION
CONCLUSIONS
A hybrid model of using SOC and USGPIV for PIV access for apheresis procedures resulted in decreased need for CVC access, high levels of successful initial access attempts, and increased nursing confidence in PIV access.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
328-334Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
Kalantari K. The choice of vascular access for therapeutic apheresis. J Clin Apher. 2012;27(3):153-159.
Salazar E, Garcia S, Miguel R, Segura FJ, Ipe TS, Leveque C. Ultrasound-guided peripheral venous access for therapeutic apheresis procedures reduces need for central venous catheters. J Clin Apher. 2017;32(4):266-269.
Pavenski K. Therapeutic apheresis. Clinical Guide to Transfusion 2018. https://professionaleducation.blood.ca/en/transfusion/guide-clinique/therapeutic-apheresis
Putensen D, Leverett D, Patel B, Rivera J. Is peripheral access for apheresis procedures underutilized in clinical practice?-a single Centre experience. J Clin Apher. 2017;32(6):553-559.
Price J, Xiao J, Tausch K, Hang B, Bahl A. Single versus double tourniquet technique for ultrasound-guided venous catheter placement. West J Emerg Med. 2019;20(5):719-725.
Sznajder JI, Zveibil FR, Bitterman H, Weiner P, Bursztein S. Central vein catheterization. Failure and complication rates by three percutaneous approaches. Arch Intern Med. 1986;146(2):259-261.
McGee DC, Gould MK. Preventing complications of central venous catheterization. N Engl J Med. 2003;348(12):1123-1133.
Egan G, Healy D, O'Neill H, Clarke-Moloney M, Grace PA, Walsh SR. Ultrasound guidance for difficult peripheral venous access: systematic review and meta-analysis. Emerg Med J. 2013;30(7):521-526.
Lapostolle F, Catineau J, Garrigue B, et al. Prospective evaluation of peripheral venous access difficulty in emergency care. Intensive Care Med. 2007;33(8):1452-1457.
Costantino TG, Parikh AK, Satz WA, Fojtik JP. Ultrasonography-guided peripheral intravenous access versus traditional approaches in patients with difficult intravenous access. Ann Emerg Med. 2005;46(5):456-461.
Bahl A, Pandurangadu AV, Tucker J, Bagan M. A randomized controlled trial assessing the use of ultrasound for nurse-performed IV placement in difficult access ED patients. Am J Emerg Med. 2016;34(10):1950-1954.
Hanafusa N, Torato T, Katagiri D, et al. Deep vein puncture under ultrasonographic guidance-an alternative approach for vascular access of apheresis therapies. J Clin Apher. 2015;30(6):380-381.
Gopalasingam N, Thomsen AE, Folkersen L, Juhl-Olsen P, Sloth E. A successful model to learn and implement ultrasound-guided venous catheterization in apheresis. J Clin Apher. 2017;32(6):437-443.
Keyes LE, Frazee BW, Snoey ER, Simon BC, Christy D. Ultrasound-guided brachial and basilic vein cannulation in emergency department patients with difficult intravenous access. Ann Emerg Med. 1999;34(6):711-714.
Brydges R, Carnahan H, Rose D, Rose L, Dubrowski A. Coordinating progressive levels of simulation fidelity to maximize educational benefit. Acad Med. 2010;85(5):806-812.
Clemmesen L, Knudsen L, Sloth E, Bendtsen T. Dynamic needle tip positioning - ultrasound guidance for peripheral vascular access. A randomized, controlled and blinded study in phantoms performed by ultrasound novices. Ultraschall Med. 2012;33(7):E321-E325.
Artino AR, La Rochelle JS, Dezee KJ, Gehlbach H. Developing questionnaires for educational research: AMEE guide no. 87. Med Teach. 2014;36(6):463-474.
Weng L-J. Impact of the number of response categories and anchor labels on coefficient alpha and test-retest reliability. Educ Psychol Meas. 2004;64(6):956-972.
van Loon F, Buise M, Claassen J, Dierick-van Daele A, Bouwman A. Comparison of ultrasound guidance with palpation and direct visualization for peripheral vein cannulation in adult patients: a systematic review and meta-analysis. Br J Anaes. 2018;121(2):358-366.
Golestaneh L, Mokrzycki MH. Vascular access in therapeutic apheresis: update 2013. J Clin Apher. 2013;28(1):64-72.
Yeral M, Boga C, Oguzkurt L, Asma S, Kasar M, Kozanoglu I. Short-term central venous catheter complications in patients with sickle cell disease who undergo apheresis. J Thromb Thrombolysis. 2014;37(2):97-101.
Zimlichman E, Henderson D, Tamir O, et al. Health care-associated infections: a meta-analysis of costs and financial impact on the US health care system. JAMA Intern Med. 2013;173(22):2039-2046.