Abstract
BackgroundIn patients with peripheral intravenous catheters (PIVCs), performing flushing is an essential procedure to maintain catheter patency and prevent complications. These PIVC related complications can lead to premature removal and therapeutics interruption, which implies the need of a new catheterization thus increasing patient discomfort and pain. AimsTo identify nursing practices related to the flushing procedure, namely: moment(s) of the flushing; the syringe size used; the flush solution, volume and technique; the knowledge and accomplishment of the recommended standards on flushing by nurses. MethodsA cross-sectional study was conducted between July and December 2017, with Brazilian and Portuguese nurses. An online questionnaire was developed based on the international recommendations on flushing procedure. Descriptive analysis was performed. ResultsA total of 76 nurses answered the questionnaire. The majority of nurses (84.2%) performed flushing: the most common technique used was continuous syringe pressure (31.2%), with the push-pause technique being performed by 23.4% of the nurses. Despite the majority performs flushing at four distinct moments (after the PIVC insertion, before, between and after drug delivery), there are inconsistencies in flush solution, volume, and syringe size. The most used volume to perform flushing was 5 mL, filled using normal saline. Despite this, they also recognized the omission of this procedure due to time constrains, no familiarity with the procedure and unavailable material. ConclusionsThis study identified that flushing procedure isn't always performed by nurses in their clinical practice. Also, several inconsistencies were observed between nurses that performed flushing, reflecting the lack of empirical evidence in this area of research.
Highlights
Peripheral intravenous catheters (PIVCs) are frequently used in hospital settings [1, 2] for a variety of purposes, but it often exposes persons to various risks, such as bloodstream infections, general discomfort, pain or swelling [2]
Some of the most frequent complications related to peripheral intravenous catheters (PIVCs) are well known in literature, as phlebitis [4, 5, 6, 7], infiltration [8] and occlusion [2, 4, 9, 10, 11], which often leads to catheter failure, intravenous therapy interruption, need for premature removal of PIVCs, being necessary a new catheterization [2, 12]
Taking into consideration the importance of the flushing procedure in reducing the PIVC related complications, this study shows a high percentage of nurses that perform flushing on their daily routine
Summary
Peripheral intravenous catheters (PIVCs) are frequently used in hospital settings [1, 2] for a variety of purposes, but it often exposes persons to various risks, such as bloodstream infections, general discomfort, pain or swelling [2]. The flushing technique is a common practice that should allow to maintain the patency of the catheter and reduce the risk of mixture of different substances by cleaning the inner lumen of the catheter [16, 17], enabling the prevention of bacterial colonization of vascular access devices [4]. In patients with peripheral intravenous catheters (PIVCs), performing flushing is an essential procedure to maintain catheter patency and prevent complications. These PIVC related complications can lead to premature removal and therapeutics interruption, which implies the need of a new catheterization increasing patient discomfort and pain. Aims: To identify nursing practices related to the flushing procedure, namely: moment(s) of the flushing; the syringe size used; the flush solution, volume and technique; the knowledge and accomplishment of the recommended standards on flushing by nurses. Several inconsistencies were observed between nurses that performed flushing, reflecting the lack of empirical evidence in this area of research
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