|
[PMID]: | 28806225 |
[Au] Autor: | Mariyaselvam MZA; Catchpole KR; Menon DK; Gupta AK; Young PJ |
[Ad] Endereço: | From the Division of Anaesthesia, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom (M.Z.A.M., D.K.M.); Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, South Carolina (K.R.C.); Cambridge University Hospitals, Addenbrooke's Hospital, Cambridge, United Kingdom (A.K.G.); and Critical Care Department, The Queen Elizabeth Hospital, Kings Lynn, United Kingdom (P.J.Y.). |
[Ti] Título: | Preventing Retained Central Venous Catheter Guidewires: A Randomized Controlled Simulation Study Using a Human Factors Approach. |
[So] Source: | Anesthesiology;127(4):658-665, 2017 Oct. | [Is] ISSN: | 1528-1175 |
[Cp] País de publicação: | United States |
[La] Idioma: | eng |
[Ab] Resumo: | BACKGROUND: Retained central venous catheter guidewires are never events. Currently, preventative techniques rely on clinicians remembering to remove the guidewire. However, solutions solely relying upon humans to prevent error inevitably fail. A novel locked procedure pack was designed to contain the equipment required for completing the procedure after the guidewire should have been removed: suture, suture holder, and antimicrobial dressings. The guidewire is used as a key to unlock the pack and to access the contents; thereby, the clinician must remove the guidewire from the patient to complete the procedure. METHODS: A randomized controlled forced-error simulation study replicated catheter insertion. We created a retained guidewire event and then determined whether clinicians would discover it, comparing standard practice against the locked pack. RESULTS: Guidewires were retrieved from 2/10 (20%) standard versus 10/10 (100%) locked pack, n = 20, P < 0.001. In the locked pack group, participants attempted to complete the procedure; however, when unable to access the contents, this prompted a search for the key (guidewire). Participants discovered the guidewire within the catheter lumen, recovered it, utilized it to unlock the pack, and finish the procedure. A structured questionnaire reported that the locked pack also improved subjective safety of central venous catheter insertion and allowed easy disposal of the sharps and guidewire (10/10). CONCLUSIONS: The locked pack is an engineered solution designed to prevent retained guidewires. Utilizing forced-error simulation testing, we have determined that the locked pack is an effective preventative device and is acceptable to clinicians for improving patient safety. |
[Mh] Termos MeSH primário: |
Cateterismo Venoso Central/instrumentação Cateteres Venosos Centrais Ergonomia Segurança do Paciente
|
[Mh] Termos MeSH secundário: |
Adulto Desenho de Equipamento Feminino Seres Humanos Masculino Manequins Meia-Idade Adulto Jovem
|
[Pt] Tipo de publicação: | JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL |
[Em] Mês de entrada: | 1710 |
[Cu] Atualização por classe: | 171116 |
[Lr] Data última revisão:
| 171116 |
[Sb] Subgrupo de revista: | AIM; IM |
[Da] Data de entrada para processamento: | 170815 |
[St] Status: | MEDLINE |
[do] DOI: | 10.1097/ALN.0000000000001797 |
|
|
|