Abstract:
BACKGROUND:Peripherally inserted central catheters (PICCs) are a common vascular access device used in clinical practice. Their use may be complicated by adverse events such as venous thromboembolism (VTE). The size of the vein used for PICC insertion and thus the catheter to vein ratio is thought to be a controllable factor in the reduction of VTE rates in patients who have a PICC. However, an optimal catheter to vein ratio for PICC insertion has not previously been investigated to inform clinical practice. OBJECTIVES:To determine the effect of the catheter to vein ratio (proportion of the vein measured at the insertion point taken up by the catheter) on rates of symptomatic VTE in patients with a PICC and identify the optimal ratio cut-off point to reduce rates of this adverse event. METHOD:Adult patients waiting for PICC insertion at a large metropolitan teaching hospital were recruited between May and December 2013. Vein diameter at the PICC insertion site was measured using ultrasound with in-built callipers. Participants were followed up at eight weeks to determine if they developed symptomatic VTE. RESULTS:Data were available for 136 patients (50% cancer; 44% infection; 6% other indication for PICC). Mean age was 57 years with 54% males. There were four cases of confirmed symptomatic VTE (two involving the deep veins, one peripheral vein and one pulmonary embolism). Receiver operator characteristic (ROC) analysis determined that a 45% catheter to vein ratio was the ideal cut off point to maximise sensitivity and specificity (AUC 0.761; 95% CI 0.681-0.830). When a ratio of 46% or above was compared to one that was less than or equal to 45% using a log binomial generalised linear model it was found that participants with a catheter to vein ratio >45% were 13 times more likely to suffer VTE (relative risk 13, p=0.022; CI 1.445-122.788). CONCLUSION:It was found that a 45% catheter to vein ratio was the optimal cut off with high sensitivity and specificity to reduce the risk of VTE. However, further research is needed to confirm these results as although adequately powered; the number of cases of VTE was comparatively small, resulting in wide confidence intervals.
journal_name
Int J Nurs Studjournal_title
International journal of nursing studiesauthors
Sharp R,Cummings M,Fielder A,Mikocka-Walus A,Grech C,Esterman Adoi
10.1016/j.ijnurstu.2014.12.002subject
Has Abstractpub_date
2015-03-01 00:00:00pages
677-85issue
3eissn
0020-7489issn
1873-491Xpii
S0020-7489(14)00332-0journal_volume
52pub_type
杂志文章abstract:BACKGROUND:Non-Hodgkin's lymphoma is a heterogeneous group of lymphoproliferative malignancies. Chemotherapy can improve patient survival rates, yet it is also associated with many adverse physical and psychosocial effects. It is suggested that qigong practices may be used to reduce patient distress and side effects. ...
journal_title:International journal of nursing studies
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ijnurstu.2017.01.004
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:The majority of individuals with an eating disorder remain undetected in healthcare. To improve the situation, screening for eating disorder symptoms is suggested to be a routine part of the health examination of adolescents. Given the busy practice of school healthcare, the screening tool needs to be brief ...
journal_title:International journal of nursing studies
pub_type: 杂志文章
doi:10.1016/j.ijnurstu.2009.04.007
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Follow-up care and surveillance are essential components of colorectal cancer survivorship. However, the relative contribution of healthcare experiences to quality of life in cancer survivorship is poorly understood. OBJECTIVES:This study explores associations between colorectal cancer survivors' healthcare...
journal_title:International journal of nursing studies
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更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:It is well established that people with schizophrenia and related serious mental illnesses die prematurely and have significantly higher medical co-morbidity compared with the general population. Mental health nurses have a key role in improving the physical health of patients but their attitudes to this asp...
journal_title:International journal of nursing studies
pub_type: 杂志文章
doi:10.1016/j.ijnurstu.2011.07.011
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Venous leg ulcers are the most common chronic wound seen in Australian primary care. Healing outcomes are protracted due to suboptimal use of clinical practice guideline recommendations. A better understanding of the differences between patients and clinicians may optimise management in primary care and impr...
journal_title:International journal of nursing studies
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更新日期:2021-01-01 00:00:00
abstract::Fatigue is frequently experienced by patients with chronic illnesses, and especially by patients with cancer and chronic obstructive airways disease. However, there is a paucity of qualitative research into the experiences of fatigued individuals and, consequently, definitions of fatigue have, to date, been based sole...
journal_title:International journal of nursing studies
pub_type: 杂志文章
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更新日期:1997-02-01 00:00:00
abstract:BACKGROUND:A number of health-related quality of life instruments for children and adolescents have been developed and used in European countries during recent years. However, few well-validated instruments have been translated into Norwegian. As part of a larger investigation about pain and health-related quality of l...
journal_title:International journal of nursing studies
pub_type: 杂志文章
doi:10.1016/j.ijnurstu.2010.10.001
更新日期:2011-05-01 00:00:00
abstract::During a grounded theory study into health visiting the role of the relationship with clients was uncovered. It was found that they have a necessary enabling and mediating function for health visitors' work. Although the literature has highlighted the importance of the relationships in health visiting, the work involv...
journal_title:International journal of nursing studies
pub_type: 杂志文章
doi:10.1016/0020-7489(94)90015-9
更新日期:1994-10-01 00:00:00
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journal_title:International journal of nursing studies
pub_type: 临床试验,杂志文章
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更新日期:2001-10-01 00:00:00
abstract:BACKGROUND:Implicit rationing of nursing care refers to the withdrawal of or failure to carry out necessary nursing care activities due to lack of resources, in the literature also described as missed care, omitted care, or nursing care left undone. Under time constraints, nurses give priority to activities related to ...
journal_title:International journal of nursing studies
pub_type: 杂志文章,多中心研究
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更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Effective self-care is the cornerstone of the successful management of heart failure (HF). The European Heart Failure Self-care Behaviour Scale is a brief, reliable and valid scale to measure this important construct among patients with HF. Although the EHFScBS has been translated to different languages, no ...
journal_title:International journal of nursing studies
pub_type: 杂志文章
doi:10.1016/j.ijnurstu.2010.08.011
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVES:To investigate the effectiveness of a risk assessment system in reducing the risk of violence in an acute care hospital in the Canadian province of British Columbia. METHODS:Hospital violence incident rates (number of incidents/100,000 work hours) were calculated and compared pre, during and post implementa...
journal_title:International journal of nursing studies
pub_type: 杂志文章
doi:10.1016/j.ijnurstu.2010.10.006
更新日期:2011-05-01 00:00:00
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journal_title:International journal of nursing studies
pub_type: 杂志文章,评审
doi:10.1016/j.ijnurstu.2010.09.005
更新日期:2011-01-01 00:00:00
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journal_title:International journal of nursing studies
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ijnurstu.2017.03.007
更新日期:2017-07-01 00:00:00
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journal_title:International journal of nursing studies
pub_type: 杂志文章
doi:10.1016/j.ijnurstu.2007.05.009
更新日期:2008-08-01 00:00:00
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journal_title:International journal of nursing studies
pub_type: 杂志文章
doi:10.1016/j.ijnurstu.2007.06.005
更新日期:2008-07-01 00:00:00
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journal_title:International journal of nursing studies
pub_type: 杂志文章,评审
doi:10.1016/j.ijnurstu.2006.01.006
更新日期:2007-01-01 00:00:00
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journal_title:International journal of nursing studies
pub_type: 杂志文章
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更新日期:1983-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.ijnurstu.2011.11.007
更新日期:2013-06-01 00:00:00
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journal_title:International journal of nursing studies
pub_type: 杂志文章
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更新日期:2015-07-01 00:00:00
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pub_type: 杂志文章
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更新日期:2009-07-01 00:00:00
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journal_title:International journal of nursing studies
pub_type: 杂志文章
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更新日期:2013-02-01 00:00:00
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journal_title:International journal of nursing studies
pub_type: 杂志文章
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更新日期:2008-02-01 00:00:00
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pub_type: 杂志文章
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更新日期:2010-06-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:2014-01-01 00:00:00
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journal_title:International journal of nursing studies
pub_type: 杂志文章
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更新日期:2020-03-01 00:00:00
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journal_title:International journal of nursing studies
pub_type: 杂志文章
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更新日期:2003-02-01 00:00:00
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pub_type: 杂志文章,评审
doi:10.1016/j.ijnurstu.2010.11.006
更新日期:2011-03-01 00:00:00
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journal_title:International journal of nursing studies
pub_type: 杂志文章,评审
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更新日期:2018-01-01 00:00:00
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journal_title:International journal of nursing studies
pub_type: 杂志文章
doi:10.1016/j.ijnurstu.2004.10.009
更新日期:2006-01-01 00:00:00