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Long-term vascular access for home parenteral nutrition and their complications
Králová, Petra ; Novák, František (advisor) ; Hocková, Jana (referee)
Home parenteral nutrition is a treatment enabling the patients with intestinal failure to live their lifes in their home environment. The possibility to commence and practise home parenteral nutrition requires not only a medical and pharmaceutical team, but also paramedical staff, which plays a signifiant part mainly in education of the patient and his close relatives. The study's aim was to characterize the patients involved in the home parenteral nutrition programme (HPN) and catheters used for this purpose and as well to analyze complication rate of the long term catheters related to their use and subsequent care. Into the retrospective quantitative study were included patiens treated with home parenteral nutrition since january 2009 to september 2015 within one nutrition care center. Data collection was realized by research in medical documentation. Altogether 135 patients were included in the study (93 female and 42 male), who have hade 227 catheters inserted in total (114 portcatheters, 73 Broviac catheters and 40 PICC) with 86 187 catheter days. The most frequent basic disease was cancer (36%) and the most prevalent indication to HPN was a short bowel syndrome (50%). Overall complication rate was 2,12/1000 catheter days (1,62 catheter sepsis, identically local infections and thrombotic...
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The importance of the nutritional score in patients with the introduced PICC or Midline catheter
Pavelková, Kateřina ; Tomová, Šárka (advisor) ; Bratová, Andrea (referee)
The bachelor's thesis: "The Significance of Nutrition Score in the patients with the insertion of PICC and Midline Catheter," evaluates the impact of the nutrition status on the presence of complication in the selected venous devices - various types of Midline catheter and PICC. The presentation is divided into theoretical and empirical parts. In the theoretical part some basic information related to nutritional status and its assessment, malnutrition, nutrition screening, PICC and Midline catheter - indications and contraindications, introduction, complications and management is presented. The role of PICC team in the field of vascular access is mentionned. Data for the empirical part was collected at Medical department of the 2nd Faculty of Medicine of Charles University and Faculty hospital Motol in Prague, Czech Republic. The empirical part contains research methodology, the basic characteristics, the organisation of the investigation and data processing. A total of 206 patients participated in the follow-up, ranging in age from 26 to 98 years, mean age 72 ± 13.2 years and median 74 years. A quantitative exploratory method of a questionnaire survey was chosen for the bachelor's thesis. The above mentionned method monitors all variables that are sorted and measurable. Data related to the...
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The influence of nursing procedures on the incidence of vascular access complications during home parenteral nutrition
Chalušová, Petra ; Meisnerová, Eva (advisor) ; Pražáková, Zuzana (referee)
(EN) Home parenteral nutrition (DPV) has become a routine part of patients care whose oral intake is reduced or completely eliminated. An integral part of the application of DPV is also the permanent or temporary need for functioning vascular access. Catheter complications negatively affect the quality of life, morbidity and in case of catheter sepsis the patient mortality. In addition it also brings increased costs for therapy and the need for patients re-hospitalization. The main objective of our study is to analyze catheter-related complications and to determine whether use of catheter plugs like TauroLock and TauroLock Hep and Tegaderm CHG antimicrobial dressing affect the incidence of catheter complications with DPV, and whether the incidence of complications is affected by a person who treated the catheter. The secondary objective is to characterize patients with served DPV and types of catheter used for this purpose.The method chosen is a retrospective observational cohort study. The study contains 52 patients with 72 catheters (39 Broviac, 18 PICC and 15 ports). The monitored number of catheter- days in total was 33,875. We conclude that the use TauroLock Hep is effective in the prevention of catheter complications and significantly reduces the overall incidence of all complications (p =...
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Long-term vascular access for home parenteral nutrition and their complications
Králová, Petra ; Novák, František (advisor) ; Hocková, Jana (referee)
Home parenteral nutrition is a treatment enabling the patients with intestinal failure to live their lifes in their home environment. The possibility to commence and practise home parenteral nutrition requires not only a medical and pharmaceutical team, but also paramedical staff, which plays a signifiant part mainly in education of the patient and his close relatives. The study's aim was to characterize the patients involved in the home parenteral nutrition programme (HPN) and catheters used for this purpose and as well to analyze complication rate of the long term catheters related to their use and subsequent care. Into the retrospective quantitative study were included patiens treated with home parenteral nutrition since january 2009 to september 2015 within one nutrition care center. Data collection was realized by research in medical documentation. Altogether 135 patients were included in the study (93 female and 42 male), who have hade 227 catheters inserted in total (114 portcatheters, 73 Broviac catheters and 40 PICC) with 86 187 catheter days. The most frequent basic disease was cancer (36%) and the most prevalent indication to HPN was a short bowel syndrome (50%). Overall complication rate was 2,12/1000 catheter days (1,62 catheter sepsis, identically local infections and thrombotic...
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Ensuring intravenous lines in children.
BENEŠOVÁ, Nikola
Intravenous cannulation ranks among the basic nursing procedures performed by nurses on everyday basis. The indications for cannulation include particularly infusion therapies, administration of replacement fluids in case of blood loss, anesthesia, long-term administration of antibiotics, parenteral nutrition or monitoring of central venous pressure. In case of children the method prevents frequent unpleasant and painful punctures. Intravenous cannulation is used for peripheral catheterization, central catheterization, umbilical catheterization and PICC. The most frequent is application of peripheral catheters. In absolute majority of cases the procedure is performed by two nurses, while one introduces a catheter and the other holds the child. It should be always made possible for the mother/accompanying person to be present during the procedure. Apart from observation of disinfection, sterility and correct procedure by nurses/ physician, it is very essential to ensure good mental preparation of the child which depends on how much the child is able to understand the provided information. The parent or another accompanying person must be sufficiently instructed in advance about the procedure. In case of introduction of a peripheral catheter in newborns and nurslings no rubber or other tourniquets are used on the limb and the limb is only pressed by the assisting nurse with adequate force. Equally as in adults, visible veins of upper and lower limbs are used for intravenous cannulation but also veins on the child´s head which is a specific place used in little children. Umbilical catheter introduced immediately after the birth is also characteristic for newborns and this procedure can be performed only by a physician, similarly as it is the case with the central catheter. PICC is different in this respect as it can be also introduced by a professionally trained nurse. Aseptic approach is always applied. All catheters must be firmly fixed to prevent their undesired extraction. After the procedure the patient and the puncture area are regularly checked to prevent complications.
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