Background Intravenous administration is an especially risky stage of medical treatment. Securing this stage, in particular handling the proper use of medical devices (MD), is important to ensure patient safety. Anaesthesia is especially hazardous due to complex infusion installations and the frequent use of a narrow therapeutics range.
Purpose The aim of this work was to evaluate the proper use of infusion MD in anaesthesia in order to lead actions to secure intravenous administration.
Material and methods An audit was conducted during 3 months in operating rooms (OR). Infusions’ installations were observed: which infusion MD were used and how.
Then, a questionnaire was distributed to nurses of the units in charge of patients after surgery, to know the becoming of infusion installations after the OR.
Results Thirty surgical interventions were observed and 37 peripherical veinous access were inserted. For 36 (97.3%) of them, a one way-valve (OWV) was directly put on the catheter.
Among these 30 infusion installations, 19 (63.3%) were simple ones, which means a catheter, a OWV and an infusion set with a three-way stopcock. The others were more complicated, with additionnal infusion sets or an infusion reheater.
Eighteen nurses answered the questionnaire. Seventeen (94.4%) revealed that patients could leave the OR with only a catheter and a OWV on it and three (16.7%) answered that OWV could be unprotected by a cap. During the change of the infusion line, eight (4.4%) nurses disconnected the line on the OWV and 12 (66.7%) let only the catheter with a OWV in the absence of perfusion.
Conclusion OWV is not a closed system. Used as a catheter cap, there is a risk of infection and gas embolism. A working group has been formed to solve the misuse of OWV. Three specific cases have been distinguished in the OR and solutions have been proposed for each one: ambulatory patients (catheter with an obturator); patients transferred in intensive care (infusion set still connected); and patients transferred in the surgical unit (catheter with a two-way valve).
A document which reminds of the proper use of OWV has been disseminated and a training workshop concerning infusion valves has been organised.
References and/or acknowledgements No references.
No conflict of interest.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.