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  • A Cross-sectional Survey on Strategies for Choosing Venous Access Devices for Critically Ill Patients

    ObjectiveTo investigate and analyze the strategies for choosing venous access devices for critically ill patients. MethodsThe medical staffs in ICU were required to fulfill a questionnaire on the knowledge and application of venous access devices in critically ill patients in May 2015.A descriptive statistical analysis was carried out on the answers generated from the questionnaire using SPSS 19.0 software. ResultsA total of 50 questionnaires were distributed randomly and 46 valid questionnaires were recovered.The effective response rate was 92.0%.The proportion of junior, intermediate and senior medical staffs was 80.4%, 13.0% and 6.6%, respectively.The proportion of doctors and nurses was 39.1% and 60.9%, respectively.The average seniority was (5.7±4.9)years.The proportion of ICU medical staffs who were acquainted with PIV, ACVC, PICC, TCVC, PORT and Midline was 100.0%, 100.0%, 100.0%, 69.6%, 43.5% and 13.0%, respectively.The proportion of ICU medicial staffs who would take the styles of drug, the time of treatment, the patients' condition and the costs into consideration when choosing venous access devices was 100.0%, 100.0%, 64.0% and 18.0%, respectively.91.3% and 39.1% of ICU medical staffs would choose PIV and ACVC respectively if the time of treatment was less than 1 week.56.5%, 69.6% and 26.1% of ICU medical staffs would choose PIV, ACVC and PICC respectively if the time of treatment was between 1 and 4 weeks.30.4%, 39.1%, 82.6% and 32.6% of ICU medical staffs would choose PIV, ACVC, PICC and PORT respectively if the time of treatment was more than 4 weeks.52.2% of ICU medical staffs were acquaint with the styles and the indication of antibiotic coating central venous catheter.The main reasons for infusion failure were poor vascular condition (91.3%), old age (52.2%), skin lesions (39.1%) and pipeline plugging (26.1%).The main reasons for choosing the peripheral vein were lower risk of infection (87.0%), short-term treatment (82.6%), common transfusion (78.3%) and antibiotic treatment (47.8%).The main reasons for choosing central venous infusion were irritant drugs (82.6%), peripheral vascular puncture difficulty (69.6%), long-term infusion (65.2%) and hemodynamic monitor (56.5%). ConclusionsIt is difficult to establish a vascular access for critically ill patients.The ICU medical staffs are experienced to PIV, ACVC and PICC but not to Midline, TCVC and PORT.A comprehensive evaluation is essential to choose a suitable and reliable venous access device for critically ill patients.

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