Evaluation of the Use of Open Versus Closed Short Peripheral Catheters on Catheter Dwell Time Short peripheral catheters (SPCs) vary by design and materials. The investigators conducted a before-and-after study comparing catheter dwell time and complications with open and closed system SPCs. Many SPCs in the study were saline locks. Results showed that the closed system SPCs had a significantly longer dwell time than open system SPCs. Complications overall were few and not different between groups. Nurse survey ratings were more positive for reduced blood spillage and materials with the closed system SPC but favored the open system SPC for ease of use when handling the catheter and venipuncture. The most common reason for discontinuing the catheter was for patient discharge.

A Comparison of 2 Venous Puncture Sites for Peripheral Implanted Ports The use of peripheral implanted ports to administer parenteral nutrition in a number of patient cohorts is increasingly seen as a safe alternative to chest ports with equivalence in long-term outcomes. Two insertion sites on the upper arm were compared using the zone insertion method (ZIM), which was developed as an approach to optimize and reduce catheter-related exit site complications. The ZIM divides the medial upper arm into 3 main colors, red, green, and yellow, which are based on musculoskeletal, skin, and vessel characteristics. The optimal exit site is considered to be the green zone, the middle third of the upper arm. Thirty-five patients were allocated to vein puncture at the yellow/green zone (group A) and 35 patients at the yellow zone near the axilla (group B). All devices were implanted in the distal green zone. Successful peripheral port implantation was 91.4% (n = 35) for group A and 100.0% (n = 35) for group B (P = .07). No procedural or postprocedural complications were observed.

Developing a Model of Care for Home Infusions of Natalizumab for People With Multiple Sclerosis Natalizumab is an effective treatment for multiple sclerosis that requires 4-weekly infusions that are usually provided in hospital outpatient clinics. In this study, a model of care (MOC), an overarching design for the provision of a health care service, was developed to permit home infusions of natalizumab. The proposed new MOC comprised 9 dimensions, in addition to the central concept of patient-centered care at home. The new MOC is responsive to patient needs and prioritizes the nurse–patient therapeutic relationship. It provides practical examples of patient-centered care to guide clinical practice for this patient population in the home setting.

A Study of Tolerability, Satisfaction, and Cost Reduction Using a 10% Immunoglobulin Product at Higher Administration Rates Gammaplex 10% (immune globulin intravenous [human], Bio Products Laboratory, Ltd) can be administered with a 15-minute rate-escalation protocol. This analysis examined safety, patient satisfaction, and cost savings in 49 patients administered Gammaplex 10% via rapid infusion over 11 months. Fourteen patients reported 38 adverse reactions, 37 of which were deemed minor/moderate. Patient satisfaction was very good/outstanding. Infusions were estimated to be 2.4 hours shorter than previously administered intravenous immunoglobulin infusions, saving $151.61 per visit in nursing costs. Rapid infusion of Gammaplex 10% was found to be a safe option to reduce the costs of intravenous immunoglobulin treatment while maintaining patient satisfaction.

Effects of Blood Transfusion Sets on Red Blood Cell Hemolysis This experimental randomized study compared the effects of macrodrop and microdrop blood transfusion sets on red blood cell (RBC) hemolysis. Twenty units of packed RBCs from different donors were infused through 48 infusion sets from 2 manufacturers at infusion rates of 10 and 100 mL/h. Pre- and postinfusion analysis was performed to determine total hemoglobin (g/dL), hematocrit (%), free hemoglobin (g/dL), potassium (mmol/L), haptoglobin (g/L), and degree of hemolysis (%). The results demonstrated that the level of free hemoglobin (P < .001) and degree of hemolysis (P < .001) increased postinfusion. A higher degree of hemolysis was noted when the RBCs were infused at a rate of 10 mL/h through a microdrop blood transfusion set.

Look How Far We've Come! No abstract available