与许多国际环境相反,葡萄牙没有外周静脉导管(PIVC)插入和维护的临床指南.我们试图就PIVC捆绑达成国际共识,以指导葡萄牙护士在此范围内的临床决策。
方法:两个国际血管通路专家小组参与了Delphi在线小组。在第一轮中,专家(n=7)收到了之前在葡萄牙一家外科病房进行的观察性研究的总结报告.根据报告的结果,专家被要求提供5至8项PIVC插入和维持干预措施.然后,另一组专家(n=7)对建议进行评分和修订,直至达成共识(≥70%的共识).提供了PIVC捆绑包,并与外科病房的护士进行了讨论。
结果:经过三轮,5项循证干预措施达成共识:(i)患者参与并评估外周静脉网络;(ii)保持无菌无接触技术;(iii)确保正确的导管包扎和固定;(iv)进行导管冲洗和锁定;(v)每次轮班时测试外周静脉导管的功能和性能.
结论:PIVC捆绑的最终版本在国际专家中达成了共识。尽管病房护士提供了积极的反馈,有必要在未来的研究中评估其在标准化PIVC护理提供方面的有效性及其对葡萄牙临床环境中护理结局的潜在影响.
Contrary to many international settings, there are no clinical
guidelines for
peripheral intravenous catheter (PIVC) insertion and maintenance in Portugal. We sought to derive an international
consensus on a PIVC bundle that could guide Portuguese nurses\' clinical decision-making in this scope.
METHODS: Two international vascular access specialist groups participated in an online Delphi panel. During the first round, specialists (n = 7) were sent a summary report from a previous observational study conducted in a surgical ward in Portugal. Based on the report findings, specialists were asked to provide five to eight PIVC insertion and maintenance interventions. Then, another set of specialists (n = 7) scored and revised the recommendations until a
consensus was reached (≥70% agreement). The PIVC bundle was made available and discussed with the surgical ward\'s nurses.
RESULTS: After three rounds, a consensus was achieved for five evidence-informed interventions: (i) involve the person and assess the
peripheral venous network; (ii) maintain an aseptic no-touch technique; (iii) ensure proper catheter dressing and fixation; (iv) perform catheter flush & lock; (v) test the
peripheral venous catheter\'s functionality and performance at each shift.
CONCLUSIONS: The final version of the PIVC bundle achieved consensus among international experts. Despite the positive feedback provided by the ward nurses, future studies are warranted to assess its effectiveness in standardizing PIVC care delivery and its potential implications for care outcomes in Portuguese clinical settings.