Jacopo Fiorini1, Giulia Venturini2, Fabio Conti2, Emanuele Funaro3, Rosario Caruso4, Mari Kangasniemi5, Alessandro Sili2. 1. Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy. 2. Nursing Department, Policlinico Tor Vergata, Rome, Italy. 3. Mediterranean Institute of Haematology, Rome, Italy. 4. IRCCS Policlinico San Donato, San Donato Milanese, Italy. 5. Department of Nursing Science, University of Eastern Finland, Kuopio, Finland.
Abstract
AIMS AND OBJECTIVES: To describe and synthesise current knowledge on the maintenance and preservation of vessels in patients who need the placement of a vascular access device. INTRODUCTION: To administer drugs, blood or intravenous fluids, nurses or doctors insert a peripheral vascular access device on the arm using the traditional approach. This approach implies that devices are blindly inserted until flow is satisfactory and all possible sites have been exhausted. A proactive approach would ensure at the outset that the best device is used for each patient, eliminating repeated attempts at cannulation. DESIGN: An integrative review was conducted using data recorded until July 2017. Searches were conducted in PubMed, Cochrane Library, CINAHL and Scopus. REVIEW METHOD: A modified version of Cooper's five-stage method and the PRISMA guidelines were used to perform the integrative review. RESULTS: Nine papers were included in this review. The patients were active participants in a proactive approach to vessel health and preservation. The involvement of each healthcare professional in vessel health and preservation improves outcomes and expands the use of a proactive approach to vascular device management. Because nurses are directly involved in the use of such devices and support patients during the decision-making process, they should take the lead in the use of the proactive approach. CONCLUSION: Despite the many documented advantages of the proactive approach to preserving vessels in many settings and healthcare systems, it has not been widely tested. Future research is needed to guarantee high-quality vessel health and preservation care, thus contributing to the development and dissemination of the proactive approach. RELEVANCE TO CLINICAL PRACTICE: The proactive approach preserves vessels for future needs, improves the delivery of the treatment plan and reduces length of stay, costs, risk of infection, complications and pain perceived by patients. This approach also ensures better use of nurses' time and vascular access device material.
AIMS AND OBJECTIVES: To describe and synthesise current knowledge on the maintenance and preservation of vessels in patients who need the placement of a vascular access device. INTRODUCTION: To administer drugs, blood or intravenous fluids, nurses or doctors insert a peripheral vascular access device on the arm using the traditional approach. This approach implies that devices are blindly inserted until flow is satisfactory and all possible sites have been exhausted. A proactive approach would ensure at the outset that the best device is used for each patient, eliminating repeated attempts at cannulation. DESIGN: An integrative review was conducted using data recorded until July 2017. Searches were conducted in PubMed, Cochrane Library, CINAHL and Scopus. REVIEW METHOD: A modified version of Cooper's five-stage method and the PRISMA guidelines were used to perform the integrative review. RESULTS: Nine papers were included in this review. The patients were active participants in a proactive approach to vessel health and preservation. The involvement of each healthcare professional in vessel health and preservation improves outcomes and expands the use of a proactive approach to vascular device management. Because nurses are directly involved in the use of such devices and support patients during the decision-making process, they should take the lead in the use of the proactive approach. CONCLUSION: Despite the many documented advantages of the proactive approach to preserving vessels in many settings and healthcare systems, it has not been widely tested. Future research is needed to guarantee high-quality vessel health and preservation care, thus contributing to the development and dissemination of the proactive approach. RELEVANCE TO CLINICAL PRACTICE: The proactive approach preserves vessels for future needs, improves the delivery of the treatment plan and reduces length of stay, costs, risk of infection, complications and pain perceived by patients. This approach also ensures better use of nurses' time and vascular access device material.