A Brief Intervention by Nurses to Reduce the Prescribing of Occluded Peripheral Venous Catheters in the Emergency Department

Обзор

Peripheral venous catheters are frequently inserted in hospitals, with approximately 25 million placed annually in France (HAS data, 2005). The occluded peripheral venous catheter with extension tubing has become the standard in some emergency departments, offering advantages such as patient mobility, the ability to perform repeated blood draws, and the administration of intravenous medications. A 2018 meta-analysis revealed that one in three devices was unnecessary. The placement of a occluded peripheral venous is associated with a more painful insertion, higher cost, and an increased risk of infection and thromboembolism, and blood samples obtained via the occluded peripheral venous catheter are more often hemolyzed than those obtained by direct venipuncture. Communication between physicians and nurses is essential to ensure optimal patient care. A brief intervention by the nurse when a physician prescribes a occluded peripheral venous catheter can help clarify the appropriateness of this prescription, which could lead to reduced pain for the patient, time savings for healthcare providers, and material cost savings for the hospital.

Вмешательства

• Другое question for the prescriber
  Once the nurse has received the doctor's order for a blood draw with a KTO, she will ask the prescribing physician: Is the KTO being prescribed for: the administration of medication? The injection of a contrast agent? A second blood draw? For each question, there are three possible answers: Yes? No? Maybe?

Первичные конечные точки

• the proportion of obturator catheters placed improperly [Срок оценки: day 1]

Вторичные конечные точки (5)

• Correlation between the physician's final decision and nurse activity [Срок оценки: day 1]
• Use of the numerical pain scale during obturator catheter placement [Срок оценки: at the end of procedure (assessed up to 20 minutes)]
• Micro-costing analysis [Срок оценки: at the end of procedure (assessed up to 20 minutes)]
• Types of intravenous medications administered [Срок оценки: day 1]
• Number of orders for obturator catheters [Срок оценки: day 1]

Критерии участия

Критерии включения

• Patients assigned a triage score of 3A, 3B, or 4 according to the French triage scale, or 3 or 4 according to the CIMU triage scale, by the triage nurse
• Patients with a blood draw order involving the placement of an occluded catheter
• Age 18 years or older
• Patients who have read and understood the information sheet
• Patients who have given their verbal consent to participate in the study
• Patients enrolled in a social security program

Критерии исключения

• Patients admitted to the emergency department with a pre-existing intravenous line
• Patients treated by the Mobile Emergency and Resuscitation Unit outside the hospital
• Patients with a blocked catheter who did not undergo an initial blood draw
• Patient with known neurocognitive disorders incompatible with informed consent
• Pregnant or breastfeeding woman
• Patient under legal guardianship (guardianship or conservatorship) or patient deprived of liberty
• Patient refusing to participate in the study
• Patient participating in another interventional research study

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Не применимо

Модель

Последовательный дизайн

Маскирование

Открытое

Основная цель

Другое

Центры проведения

Франция · 16 центров

• CHU Amiens — Amiens
• CHU Angers — Angers
• Chu Clermont Ferrand — Clermont-Ferrand
• APHP Henri Mondor — Créteil
• Ch Dieppe — Dieppe
• APHP CH Simone Veil — Eaubonne
• HCL Lyon Sud — Lyon
• HIA Laveran Marseille — Marseille
• … и ещё 8 центров

Идентификаторы

NCT: NCT07584590 · 2023/0302/HP

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

Открыть это исследование на ClinicalTrials.gov ↗