Q-syte Connector on Prevention of Thrombophlebitis

Q-syte Connector on Prevention of ThrombophlebitisCHAPTER IINTRODUCTIONTo do what nobody else will do, a way that nobody else can do, inspite of all we go through is to be a nurse. Rawsi Williams.RN.The first principle to enunciate in a hospital is do the sick no harm (Florence Nightingale, 1859). Curing is a part of doctors and caring is in nurses domain. The intravenous (IV) cannulization is a very common procedure which is performed by nurses to save the lives of the patients. Though IV therapy saves the life if it is not handled well it will progeny in m whatever complications.Carson.D. et al, stated in 2012 that the history of IV therapy was trailed during the gist Ages. The first experiments using IV therapy were carried out in the 17th century using quills and animals bladder. In 1831-1832, Dr. Thomas Latta pioneered the use of the IV saline infusion for the cholera epidemic. It was then established as a routine medical practice during World War II. By the 1990s, it was esti mated that 85% of hospitalized patients in the US received IV therapy.A nursing survey in 1990 found that 75% of a nurses hospital time was spent providing IV therapy related services. The most frequent complication of encircling(prenominal) intravenous (PIV) infusion is phlebitis, which may occur at vagabonds as high as 50%,or even 75% for patients with infectious diseases however, the incidence rate of urgent catheter insertion is approximately 20%. Although the incidence of IV infusion-related infections is difficult to determine, studies have shown that between 5% and 25% of encircling(prenominal) catheters are colonized by skin organisms at the time of removal.(Aston 1990).Ortega, et.al, (2008) observed that the ability to obtain PIV access is an essential skill for all nurses. Although this technique is considered as a simple incursive procedure, mastering the skill requires experience and is of substantial significance in life-saving intervention. According to Waitt ,C. a nd Waitt, P., approximately 80% of patients are receiving IV therapy during their hospitalisation. The IV therapy is commonly used to adapt fluid and electrolyte imbalance, for medication administration, for blood transfusion, etc. When comparing with otherwise routes, the IV route is faster for fluid resuscitation and medication administration.In 2003, Macklin found that IV therapy has virtually common complications like phlebitis, infiltration, hematoma, extravasations, embolism, catheter related blood stream infections, etc. Drug induced thrombophlebitis is 25% to 70% comparatively higher in clinical linguistic context for patients who are receiving IV therapy.Luer Access Split Septum (LASS) eliminates the internal complexities of mechanical valves, and with them the places that may harbour microorganisms. Studies found that patients are on average three times to a greater extent likely to develop a Catheter Related Blood Stream Infection (CRBSI) with the use of mechanical v alves vs. a split-septum needless access system.NEED FOR THE STUDYPIV cannulation is a very common invasive procedure performed by nurses throughout their duty schedule. The IV cannulation procedure is simple but it requires a exercise set of skills. If the cannulised site is disturbed or not maintained properly it may result in many other complications which increase the number of days in hospital as well as the cost of treatment. The intravenous catheter related infections (CRI) come under the quality indicators of a hospital. As nurses we should therefore follow our ethical motive and improve the quality of our nursing tutelage by implementing evidence based innovative principles.In 2001, Reineck observed that maintenance of IV cannula obviousness is important to clip the patient discomforts like visible scaring and CRI. Black et al., in 1997, found that blood clots may form in the IV line as a result of kinked IV tubing, very slow infusion rate, solution administration, etc.Th e CDC recommends according to 2011 guidelines, that when needleless systems are used, a split septum valve may be preferred over round mechanical valves collectable to an increased risk of infection with the latter ones. Recently, updated guidelines from the CDC set aside a critical new evidence based intervention of Q-Syte which helps to overcome the challenges of CRBSI. When compared to the other conjunctives, the Q-Syte or the mechanical valve splitseptum devices have 64% to 70% lower CRBSI rates.Salgado, D.C., et al , conducted a study to determine whether needleless mechanical valve device have any influence on catheter related blood stream infection among patients with a central venous catheter . He found that there was a marked moderate in the incidence of CRBSI .The investigator during her clinical experience observed that many patients who received intermittent IV drug therapy suffered from thrombophlebitis, being thus the primary typesetters case of infection. Some s tudies as well as the CDC recommend to use of luer lock access along with the IV cannula. This motivated the researcher to study and to found more alternatives for preventing thrombophlebitis.STATEMENT OF THE PROBLEMEffectiveness of Q-Syte Connector on Prevention of thrombophlebitis , IV Line Patency and Ease of Administration of Medication Among the Patients with Peripheral IV Cannula in KMCH, Coimbatore.OBJECTIVESThe objectives of the study are toassess the magnitude of concomitant of thrombophlebitis and IV line patency among patients with a Q-Syte connectorcompare the occurrence of thrombophlebitis and IV line patency among patients with a Q-Syte connector and those who do not have a Q-Syte connectorcompare the ease of administration of medication for patients connected with Q-Syte and those without Q-Syte connectorassociate the occurrence of thrombophlebitis and peripheral line occlusion with demographic variables.OPERATIONAL DEFINITIONQ- SYTEA Luer Access Split Septum device connector which can be connected to the peripheral IV line.PATENCY An absence of blockage in PIV line as observed by the flow of fluid without resistance.THROMBOPHLEBITIS An inflammation of blood vessel due to blood clot. HYPOTHESISH1 There is a significant difference in the occurance of thrombophlebitis between the patients with Q-Syte and those who are without Q-Syte in preventing of thrombophlebitis.H2 There is a significant difference in maintaining the IV line patency between the patients with Q-Syte and patients without Q-Syte.H3- There is a significant difference in easing the administration of medication between the patients with Q-Syte and patients without Q-Syte .ASSUMPTION diaphragm of a PIV line may result in the development of thrombophlebitis.Q-Syte prevents the occlusion of PIV line by preventing air entry and backflow.CONCEPTUAL FRAMEWORKThe conceptual mannequin of this study was based on the modified Kolcaba comfort model. This theory was developed by Katharine K olcaba in1990 and modified again by her in 2010.HEALTH CARE askHealth care needs are those identified by the patient or its family in a particular practice setting.In the present study, the health care needs were the prevention from thrombophlebitis and the maintenance of IV line patency among the patients receiving IV drugs.HEALTH SEEKING BEHAVIOURWhen patients and families are accustomed to the actions of the health care personnel (i.e. nurses), they can involve better in the health seeking behaviour which can be internal or external.In the present study, health seeking behaviours were internal when about the prevention of thrombophlebitis and external behaviour when about the functional outcome.INTERVENING VARIABLESIntervening variables are those which are not likely to transform and over which the providers have a very little control such as prognosis, financial situations, the extent of social support, etc.In the present study, the interact variables were prognosis and the extent of the social support system around the patient.COMFORT INTERVENTIONComfort is an immediate desirable outcome of nursing care. Nurses traditionally provide comfort to patients and their families through interventions that can be called comfort measures. The intentional comforting nursing actions strengthen the patients and their family.In the present study, the comfort measure was the setting of Q-Syte connector along with the IV cannula in the experimental group and not in the control group.ENHANCED COMFORTEnhanced comfort is an immediate desirable outcome of nursing care.In the present study, the enhanced comfort was the relief from thrombophlebitis by maintaining the IV patency.INSTITUTIONAL INTEGRITYInstitutional integrity is defined as the values, the financial stability and the wholeness of health care organisations at local, regional, state and national levels.In the present study, the institutional integrity was the financial stability and the wholeness of the hea lth care organisation.7. BEST PRACTICEBest practices are the protocols and the procedures developed by an institution after collecting evidence on specific applications on the patient.In the present study, the best practice was the setting of Q-Syte connectors along with IV cannula for patients receiving such injections.1