目的:通过不同学科专家的意见,确定住院患者外周静脉导管(PVC)相关性静脉炎管理相关护理实践的共识和重要性。
背景:PVC通常用于医院,但与静脉炎等并发症有关。他们的管理差异很大,研究是异质的。
方法:德尔菲法。
方法:四个阶段:问题领域(2022年7月,WebofScience文献计量学综述),小组成员,两个Delphi回合和结束标准。在Delphi调查中,专家根据评估回答了在线问卷,治疗和随访维度(2022年9月-2023年2月)。对频率进行了统计分析,百分比,测量中心趋势和分散水平(QD)。创建了一个注释空间,并对它们进行了主题分析。
结果:18位专家(护士,医生和药剂师)参加了Delphi回合。确定了45项活动:19项在评估中,治疗中15例,随访中11例。在五个活动中发现了较高的共识水平(QD≤0.6)(11.12%),中等水平(0.61.0)21(46.66%)。确定了七个主题(患者视角,缺乏共识,低循证实践,分阶段治疗,预防活动,实践和专家团队以及跨学科工作的高度可变性)。
结论:系统评估量表的重要性与体征和症状(疼痛,发红,炎症,明显的脐带和硬结)。强调根据严重程度和日常视觉记录和监测进行治疗,同时需要患者参与和医疗保健素养。11%的活动达成了高度共识,显示静脉炎管理的标准和干预措施差异很大。突出的需求包括在团队中工作,使用专家团队并促进基于证据和预防的活动。
结论:注意到临床变异性,因此,关于PVC静脉炎标准化护理和循证实践的共识的重要性。
■德尔菲研究(CRDES)。
■专家贡献。
OBJECTIVE: To determine the consensus and importance of care practices related to the management of peripheral venous catheter (PVC)-related phlebitis in hospitalized patients through the views of experts from different disciplines.
BACKGROUND: PVCs are commonly used in hospitals but are associated with complications such as phlebitis. Their management differs widely, and studies are heterogeneous.
METHODS: Delphi method.
METHODS: Four stages: problem area (with Web of Science bibliometric review in July 2022), panel members, two Delphi rounds and closing criteria. In the Delphi survey, experts answered an online questionnaire based on assessment, treatment and follow-up dimensions (September 2022-February 2023). Statistical analyses were conducted of frequencies, percentages, measures of central tendency and levels of dispersion (QD). A space for comments was created, and a thematic analysis conducted of them.
RESULTS: Eighteen experts (nurses, doctors and pharmacists) participated in the Delphi rounds. Forty-five activities were identified: 19 in assessment, 15 in treatment and 11 in follow-up. A high consensus level (QD ≤ 0.6) was found in five activities (11.12%), moderate level (0.6 < QD < 1.0) in 19 (42.22%) and low level (QD > 1.0) in 21 (46.66%). Seven themes were determined (patient perspective, lack of consensus, low evidence-based practices, stage-based treatments, prevention activities, high variability in practice and specialist teams and interdisciplinary work).
CONCLUSIONS: The importance of systematic assessment scales is highlighted together with consensus on signs and symptoms (pain, redness, inflammation, palpable cord and induration). Treatment according to severity and daily visual recording and monitoring are emphasized along with the need for patient participation and healthcare literacy. A high level of consensus was obtained in 11% of the activities, showing the large variability of criteria and interventions for phlebitis management. Highlighted needs include working in a team, the use of specialist teams and promoting evidence- and prevention-based activities.
CONCLUSIONS: Clinical variability is noted and, therefore, the importance of consensus on standardized care for PVC phlebitis and evidence-based practice.
UNASSIGNED: Delphi studies (CREDES).
UNASSIGNED: Experts contribution.