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Perifert insatt central venkateter - En jämförelse mellan två inläggningsmetoder

Schalén, Maria LU and Larsson, Marcus LU (2012) STAH11 20112
Department of Statistics
Abstract
Peripherally inserted central venous catheter, piccline, is becoming more common in Swedish hospitals. Picclines have been used at Skånes oncological clinic since 2002 and a new insertion technique was introduced in 2008. Previously the catheter was inserted in a visible vein in the arm. With the new insertion technique it can be placed in a vein in the upper arm using ultrasound. On behalf of Skånes oncological clinic, the incidence of complications before and after the introduction of this ultrasound technique was evaluated.
Data were collected retrospectively by the nurses at the oncological clinic. A total of 502 patients were included in the study. Out of those, 250 picclines were inserted in patients antecubital and 252 were... (More)
Peripherally inserted central venous catheter, piccline, is becoming more common in Swedish hospitals. Picclines have been used at Skånes oncological clinic since 2002 and a new insertion technique was introduced in 2008. Previously the catheter was inserted in a visible vein in the arm. With the new insertion technique it can be placed in a vein in the upper arm using ultrasound. On behalf of Skånes oncological clinic, the incidence of complications before and after the introduction of this ultrasound technique was evaluated.
Data were collected retrospectively by the nurses at the oncological clinic. A total of 502 patients were included in the study. Out of those, 250 picclines were inserted in patients antecubital and 252 were inserted in the upper arm using the ultrasound technique.
Fisher's exact test shows that the ultrasound guided insertion technique leads to a reduction in the rate of infections. Logistic regression method showed that the only explanatory variable is "puncture site". We also observed that the number of failed insertions was less with the ultrasound technique. No significant difference was observed in the frequency of thromboses using the different methods.
The conclusion of the study is that piccline insertion with ultrasound guided technique is preferable. For the individual patient it means less discomfort and pain due to fewer complications. This leads to better quality of life and patient satisfaction. (Less)
Abstract (Swedish)
Perifert insatt central venkateter, piccline, blir allt vanligare inom svensk sjukvård. Vid Skånes onkologiska klinik i Lund har man sedan 2002 använt piccline och 2008 introducerade kliniken en ny inläggningsteknik. Tidigare hade man lagt in katetern via ett synligt kärl i armvecket. Den nya inläggningstekniken innebär att man lägger in katetern i ett kärl i överarmen med hjälp av ultraljud. På uppdrag av Skånes onkologiska klinik har vi utvärderat förekomsten av komplikationer före och efter introducerandet av ultraljudtekniken.
Data insamlades retrospektivt genom journalgranskning av sjuksköterskor på onkologiska kliniken. Totalt 502 patienter ingår i studien, varav 250 har fått piccline inlagd i armvecket och 252 har fått piccline... (More)
Perifert insatt central venkateter, piccline, blir allt vanligare inom svensk sjukvård. Vid Skånes onkologiska klinik i Lund har man sedan 2002 använt piccline och 2008 introducerade kliniken en ny inläggningsteknik. Tidigare hade man lagt in katetern via ett synligt kärl i armvecket. Den nya inläggningstekniken innebär att man lägger in katetern i ett kärl i överarmen med hjälp av ultraljud. På uppdrag av Skånes onkologiska klinik har vi utvärderat förekomsten av komplikationer före och efter introducerandet av ultraljudtekniken.
Data insamlades retrospektivt genom journalgranskning av sjuksköterskor på onkologiska kliniken. Totalt 502 patienter ingår i studien, varav 250 har fått piccline inlagd i armvecket och 252 har fått piccline inlagd i överarmen med ultraljudteknik.
Fishers exakta test visar att den ultraljudguidade inläggningstekniken leder till en minskad infektionsfrekvens. Med logistisk regression kunde vi visa att den enda förklarande variabeln är ”insticksställe”. Vi kunde även se att med den ultraljudguidade inläggningstekniken blev det lägre antal misslyckade inläggningar. Vi kunde inte påvisa någon signifikant skillnad av frekvensen tromboser vid de olika metoderna.
Studien visar att piccline med ultraljudguidad teknik är att föredra. För den enskilde patienten innebär det minskat obehag och smärta på grund av färre komplikationer. Det leder i sin tur till bättre livskvalitet och patienttillfredsställelse. (Less)
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author
Schalén, Maria LU and Larsson, Marcus LU
supervisor
organization
course
STAH11 20112
year
type
M2 - Bachelor Degree
subject
keywords
Fisher’s exact test, infection, complication, piccline, odds ratio, logistic regression, failed insertion, thrombosis
language
Swedish
id
2429888
date added to LUP
2012-04-02 20:12:21
date last changed
2012-04-02 20:17:11
@misc{2429888,
  abstract     = {Peripherally inserted central venous catheter, piccline, is becoming more common in Swedish hospitals. Picclines have been used at Skånes oncological clinic since 2002 and a new insertion technique was introduced in 2008. Previously the catheter was inserted in a visible vein in the arm. With the new insertion technique it can be placed in a vein in the upper arm using ultrasound. On behalf of Skånes oncological clinic, the incidence of complications before and after the introduction of this ultrasound technique was evaluated.
Data were collected retrospectively by the nurses at the oncological clinic. A total of 502 patients were included in the study. Out of those, 250 picclines were inserted in patients antecubital and 252 were inserted in the upper arm using the ultrasound technique.
Fisher's exact test shows that the ultrasound guided insertion technique leads to a reduction in the rate of infections. Logistic regression method showed that the only explanatory variable is "puncture site". We also observed that the number of failed insertions was less with the ultrasound technique. No significant difference was observed in the frequency of thromboses using the different methods. 
The conclusion of the study is that piccline insertion with ultrasound guided technique is preferable. For the individual patient it means less discomfort and pain due to fewer complications. This leads to better quality of life and patient satisfaction.},
  author       = {Schalén, Maria and Larsson, Marcus},
  keyword      = {Fisher’s exact test,infection,complication,piccline,odds ratio,logistic regression,failed insertion,thrombosis},
  language     = {swe},
  note         = {Student Paper},
  title        = {Perifert insatt central venkateter - En jämförelse mellan två inläggningsmetoder},
  year         = {2012},
}