Cateterismo venoso periférico: compreensão e avaliação das práticas de enfermagem

Luciene Muniz Braga; Anabela de Sousa Salgueiro-Oliveira; Maria Adriana Pereira Henriquesº; Cristina Arreguy-Sena; Virginia Mirian Pianetti Albergaria; Pedro Miguel dos Santos Dinis Parreira

Luciene Muniz Braga Universidade Federal de Viçosa (Viçosa, Minas Gerais, Brasil)
Anabela de Sousa Salgueiro-Oliveira Escola Superior de Enfermagem de Coimbra (Coimbra, Portugal)
Maria Adriana Pereira Henriquesº Escola Superior de Enfermagem de Coimbra (Coimbra, Portugal)
Cristina Arreguy-Sena Universidade Federal de Juiz de Fora. Faculdade de Enfermagem (Juiz de Fora, Minas Gerais, Brasil)
Virginia Mirian Pianetti Albergaria Escola Superior de Enfermagem de Coimbra (Coimbra, Portugal)
Pedro Miguel dos Santos Dinis Parreira Escola Superior de Enfermagem de Coimbra (Coimbra, Portugal)

Palabras clave: Cateterismo periférico, Dispositivos de acceso vascular, Enfermería, Seguridad del paciente, Tecnología

Key-words: Peripheral catheterization, Vascular access devices, Nursing, Patient safety, Technology

Palavras chave: Cateterismo periférico, Dispositivos de acesso vascular, Enfermagem, Segurança do paciente, Tecnologia

Resumen

Objetivo: comprender las prácticas de enfermería relacionadas con el cateterismo venoso periférico y analizar la incidencia de complicaciones durante la permanencia del catéter venoso en el paciente. Método: delineamiento mixto, involucrando: estudio de caso, estudio seccional, estudio de cohorte y grupo focal. La muestra está formada por las enfermeras y los pacientes en un servicio de clínica médica de Portugal. Se realizó un análisis temático y estadístico descriptivo. Resultados: se identificaron estresores capaces de influenciar las prácticas de enfermería, siendo ellos: las decisiones del equipo médico, la edad y las características de la red venosa del paciente, la disponibilidad de otros catéteres por la institución y el bajo nivel de conocimiento de los enfermeros sobre los cuidados a los pacientes en la inserción, mantenimiento y remoción del catéter venoso central de inserción periférica. En los pacientes portadores de catéter venoso periférico, se documentó las siguientes complicaciones y sus respectivas incidencias: flebitis (22,2%), obstrucción (27,7%), salida de fluido por la inserción (36,1%), infiltración (38) , 8%) y eliminación accidental del catéter (47,2%). En aquellos que usaron el catéter venoso central de inserción periférica, se identificó sólo la obstrucción de ese catéter, con incidencia del 22,2%. Se verificaron los siguientes beneficios con la utilización del catéter venoso central de inserción periférica: administración segura de medicamentos y reducción del dolor, del número de punciones venosas y de complicaciones. Conclusión: el catéter venoso central de inserción periférica se presenta como alternativa válida y viable para mejorar la calidad de la asistencia de enfermería, la seguridad y el bienestar de los pacientes

Abstract

Objective: to understand the nursing practices related to peripheral venipuncture and to analyze the incidence of complications in patients with venous catheters. Method: mixed design, involving: case study, sectional study, cohort study and focus group. The sample consisted of nurses and patients from a medical clinic in Portugal. Thematic analysis and descriptive statistics were performed. Results: stressors capable of influencing nursing practices were identified, including: the decisions of the medical team, the age and characteristics of the venous network of the patient, the availability of other catheters in the institution, the low level of knowledge of nurses regarding the care of patients in the insertion, maintenance and removal of the peripherally inserted central venous catheter. The following complications and their respective incidences were documented in patients with peripheral venous catheters: phlebitis (22.2%), obstruction (27.7%), fluid exiting through insertion site (36.1%), infiltration (38.8%) and accidental catheter removal (47.2%). Catheter obstruction was the only observed complication on the central venous catheter, with the incidence of 22.2%. The following benefits were observed with the use of the peripherally inserted central venous catheter: safe administration of drugs; pain reduction, number of venous punctures and complications. Conclusions: the peripherally inserted central venous catheter is presented as a valid and viable alternative that can improve the quality of nursing care and the safety and well-being of patients

Resumo

Objetivo: compreender as práticas de enfermagem relacionadas com o cateterismo venoso periférico e analisar a incidência de complicações durante a permanência do cateter venoso no paciente. Método: delineamento misto, envolvendo: estudo de caso, estudo seccional, estudo de coorte e grupo focal. A amostra foi constituída por enfermeiros e pacientes de um serviço de clínica médica de Portugal. Efetuada análise temática e estatística descritiva. Resultados: identificou-se estressores capazes de influenciar as práticas de enfermagem, sendo eles: as decisões da equipe médica, a idade e as características da rede venosa do paciente, a disponibilização de outros cateteres pela instituição e o baixo nível de conhecimento dos enfermeiros sobre os cuidados aos pacientes na inserção, manutenção e remoção do cateter venoso central de inserção periférica. Nos pacientes portadores de cateter venoso periférico, documentou-se as seguintes complicações e suas respectivas incidências: flebite (22,2%), obstrução (27,7%), saída de fluido pela inserção (36,1%), infiltração (38,8%) e remoção acidental do cateter (47,2%). Naqueles que usaram o cateter venoso central de inserção periférica, identificou-se apenas a obstrução desse cateter, com incidência de 22,2%. Verificou-se os seguintes benefícios com a utilização do cateter venoso central de inserção periférica: administração segura de medicamentos e redução da dor, do número de punções venosas e de complicações. Conclusão: o cateter venoso central de inserção periférica apresenta-se como alternativa válida e viável para melhorar a qualidade da assistência de enfermagem, a segurança e o bem-estar dos pacientes

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Cateterismo venoso periférico: compreensão e avaliação das práticas de enfermagem

Peripheral venipuncture: comprehension and evaluation of nursing practices

Cateterismo venoso periférico: comprensión y evaluación de las prácticas de enfermería

Resumen

Abstract

Resumo

Bibliografía