Exploring factors associated with failure of totally implanted vascular access devices in a regional and rural health service: a retrospective case–control study
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| Titel: | Exploring factors associated with failure of totally implanted vascular access devices in a regional and rural health service: a retrospective case–control study |
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| Autoren: | Carolyn Meredith, Gordon TW Mander, Murray Thompson, Jessica Elliott, Lorraine Reynolds, Linda Ng |
| Quelle: | BMJ Open Qual BMJ Open Quality, Vol 13, Iss 3 (2024) |
| Verlagsinformationen: | BMJ, 2024. |
| Publikationsjahr: | 2024 |
| Schlagwörter: | Male, Adult, Medicine (General), nurses, 03 medical and health sciences, R5-920, 0302 clinical medicine, Risk Factors, 80 and over, Vascular Access Devices/standards, Humans, Rural Health Services/statistics & numerical data, outcome assessment, Original Research, Retrospective Studies, Aged, Aged, 80 and over, Australia, health professions education, Middle Aged, health care, health services research, 3. Good health, Logistic Models, Case-Control Studies, Female, Rural Health Services, management, Vascular Access Devices |
| Beschreibung: | Background The assessment and management of totally implanted vascular access devices (TIVAD) prior to the administration of medications/fluids are vital to ensuring the risk of harm is mitigated. While numerous guidelines exist for the insertion and management of TIVAD, the level of evidence and external validity to support these guidelines is lacking. Objectives The purpose of this study was to identify factors associated with suboptimal TIVAD placement and with failure of TIVAD. Methods A retrospective case–control study (n=80) was conducted at a regional hospital and health service in Australia. Binomial logistic regression analysis was performed using a backward selection approach to establish variables associated suboptimal TIVAD placement and with TIVAD failure. Findings Significant associations were identified between the patient’s primary diagnosis and suboptimal TIVAD insertion. Specifically, a prior diagnosis of breast cancer was associated with a decreased probability of optimal TIVAD tip placement (OR=0.236 (95% CI 0.058 to 0.960), p=0.044). A statistically significant association between TIVAD failure and the log of the heparinised saline flush rate and rate of undocumented flushes was also established. Further research is needed to identify and assess whether modification of these variables improves initial totally implantable venous access ports placement and risk of subsequent failure. |
| Publikationsart: | Article Other literature type |
| Dateibeschreibung: | application/pdf |
| Sprache: | English |
| ISSN: | 2399-6641 |
| DOI: | 10.1136/bmjoq-2024-002799 |
| Zugangs-URL: | https://pubmed.ncbi.nlm.nih.gov/39117394 https://doaj.org/article/b65c0d259ed8472ba6b230b0ad829cb1 |
| Rights: | CC BY NC URL: http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (http://creativecommons.org/licenses/by-nc/4.0/) . |
| Dokumentencode: | edsair.doi.dedup.....0298f1c7785a632bf41c265c95349ab8 |
| Datenbank: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstract: | Background The assessment and management of totally implanted vascular access devices (TIVAD) prior to the administration of medications/fluids are vital to ensuring the risk of harm is mitigated. While numerous guidelines exist for the insertion and management of TIVAD, the level of evidence and external validity to support these guidelines is lacking. Objectives The purpose of this study was to identify factors associated with suboptimal TIVAD placement and with failure of TIVAD. Methods A retrospective case–control study (n=80) was conducted at a regional hospital and health service in Australia. Binomial logistic regression analysis was performed using a backward selection approach to establish variables associated suboptimal TIVAD placement and with TIVAD failure. Findings Significant associations were identified between the patient’s primary diagnosis and suboptimal TIVAD insertion. Specifically, a prior diagnosis of breast cancer was associated with a decreased probability of optimal TIVAD tip placement (OR=0.236 (95% CI 0.058 to 0.960), p=0.044). A statistically significant association between TIVAD failure and the log of the heparinised saline flush rate and rate of undocumented flushes was also established. Further research is needed to identify and assess whether modification of these variables improves initial totally implantable venous access ports placement and risk of subsequent failure. |
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| ISSN: | 23996641 |
| DOI: | 10.1136/bmjoq-2024-002799 |