The Impact of Home Infusion Therapies on Caregivers

Background Vascular access devices (VAD), centrally (CVAD) or peripherally (PIV) located, are common in the nursing profession. A high proportion of admitted patients require a VAD to enable administration of intravenous treatments or diagnostic modalities. As the primary caregivers for these patients, nurses are responsible for ongoing care and maintenance of these devices. Objective This scoping review examines the current state of practicing nurses knowledge around routine care and maintenance of adult VADs. Methods In the fall of 2018, the following databases were searched: Medline-Ovid 1946 to current, Embase-Ovid 1947 to current, Ebsco CINAHL Plus with full text and ProQuest Nursing & Allied Health database, and articles were selected according to the PRISMA-ScR checklist. Inclusion criteria original research published in peer-reviewed journals; in English or French; and focused on practising nurses' knowledge about the routine care and maintenance of adult VADs. Results Of the 4,099 abstracts identified, 36 full-text articles were included. Study characteristics are reportedin addition to themes found in the literature: the relationship between demographic data and CVAD/PIV knowledge, the state of nurses' CVAD/PIV knowledge and nurses' CVAD/PIV knowledge scores. Overall, significant gaps in nurses' knowledge on the care and maintenance of VADs are noted. Conclusion The variability in nurses' knowledge around both CVAD and PIV led the authors to conclude that there is room for improvement in the educational preparation of nurses and a need for workplace training. Relevance to clinical practice This scoping review intends to highlight the knowledge gap of nurses with regard to best practices for VAD routine care and maintenance and demonstrate the need for education, both in educational and healthcare institutions, to ensure high-quality care and improved patient outcomes.

Nurses' knowledge on routine care and maintenance of adult vascular access devices: A scoping review.

Several recent literature reports regarding the flushing technique of TIVADs highlight how the definition of the optimal flushing interval is still a source of controversy. Several recent studies i...

https://journals.sagepub.com/doi/pdf/10.1177/1129729820959928

Extending the interval of flushing procedures of totally implantable vascular access devices in cancer patients: It is time for a change

Mechanism of pulsatile flushing technique for saline injection via a peripheral intravenous catheter.

IntroductionBlinatumomab is an anticancer drug used in the treatment of Acute Lymphoblastic Leukaemia (ALL) in both adults and children. ALL is the most common form of cancer in children and patien...

Pediatric blinatumomab preparation: Risk assessment on SmPC for software compliance

Flushing is an essential strategy in maintaining patency of a central vascular access device. However, there is no standard practice regarding flushing techniques. Pulsatile flushing has been discussed in the past based on the principles of fluid dynamics. Recently, in vitro studies regarding pulsatile flushing have shed light on the usefulness of this technique. A critique of the current literature regarding pulsatile flushing compared with standard continuous flushing is presented here.

Pulsatile Flushing: A Review of the Literature.

Blinatumomab has shown great potential for patients with chemotherapy-resistant B-cell acute lymphocytic leukemia. Blinatumomab's toxicity profile includes central nervous system toxicities, as well as cytokine release syndrome. Although neurological toxicities associated with blinatumomab are almost always reversible, early detection and intervention of these toxicities is vital to ensure that patients continue their full course of treatment. Guidelines for the preparation and administration of blinatumomab in both inpatient and outpatient settings, as well as a standardized neurological nursing assessment, were developed to ensure safe and effective administration of blinatumomab.

Christina Boord

Papers

Pulsatile Flushing: A Review of the Literature.

Addressing Administration Challenges Associated With Blinatumomab Infusions: A Multidisciplinary Approach.