Leading change: Retrospective evaluation of a nurse-led initiative in vascular access options for autologous stem cell transplant recipients ranging from Hickman catheters to peripherally inserted central catheters.
Central venous access is essential for patients undergoing autologous hematopoietic stem cell transplantation (ASCT). Traditionally, tunneled silastic catheters have been inserted in these patients. However, changes in resource allocation, resulting in reduced surgery and surgeon time and decreasing toxicity associated with ASCT, have caused changes in venous access needs and options. This led the advanced practice nurse in the transplant program to evaluate other central access devices, which resulted in the introduction of peripherally inserted central catheters (PICCs) for this patient population. This study reports the results of a retrospective analysis comparing efficacy and complication profiles between 50 patients with the traditional Hickman catheter and 70 patients with PICCs.
Blood and Marrow Transplant Program, Ottawa Hospital-General Campus, Ontario, Canada. smcdiarmid@ottawahospital.on.ca
Sheryl
S
McDiarmid
Linda
L
Hamelin
L B
LB
Huebsch
D000328:Adult; D002170:Canada; D002405:Catheterization, Central Venous / Q000009:adverse effects / Q000295:instrumentation* / Q000451:nursing; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000295:instrumentation* / Q000451:nursing; D002408:Catheters, Indwelling / Q000009:adverse effects / Q000592:standards*; D015400:Clinical Nursing Research; D003428:Cross Infection / Q000209:etiology; D004867:Equipment Design; D004868:Equipment Failure; D004869:Equipment Safety; D005240:Feasibility Studies; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000295:instrumentation* / Q000451:nursing; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010689:Phlebitis / Q000209:etiology; D012189:Retrospective Studies; D013927:Thrombosis / Q000209:etiology; D014182:Transplantation, Autologous / Q000295:instrumentation* / Q000451:nursing; D016896:Treatment Outcome