Fatores associados à punção venosa periférica difícil em adultos

• Ano de defesa: 2018
• Autor(a) principal: MONTEIRO, Damiana Aparecida Trindade
• Orientador(a): TOFFANO, Silmara Elaine Malaguti
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Federal do Triângulo Mineiro
• Programa de Pós-Graduação: Programa de Pós-Graduação Stricto Sensu em Atenção à Saúde
• Departamento: Instituto de Ciências da Saúde - ICS::Curso de Graduação em Enfermagem
• País: Brasil
• Palavras-chave em Português: Cateterismo Periférico.; Enfermagem.; Segurança do Paciente.; Adulto.; Hospitalização.
• Palavras-chave em Inglês: Catheterization, Peripheral.; Nursing.; Patient Safety.; Adult.; Hospitalization.
• Palavras-chave em Espanhol: Cateterismo Periférico.; Enfermería.; Seguridad del Paciente.; Adulto.; Hospitalización.
• Área do conhecimento CNPq: Enfermagem
• Link de acesso: http://bdtd.uftm.edu.br/handle/tede/737

Introduction: The practice of peripheral intravenous access is a routine procedure in the hospital environment. In clinical practice, it is observed that veins are punctured to exhaustion, which reflects pain and discomfort for those involved, as well as material costs, delayed initiation of infusion therapy and risk of complications. The preference relative to the use of the peripheral venous catheter is for the fact that it is a low-cost option, with a lower risk of bloodstream infection and insertion convenience. Nursing is directly involved in this process, being responsible for puncture and care related to maintenance and removal. Objective: To determine the prevalence and factors associated with difficult venous access in adults admitted into a general public teaching hospital. Methodology: This is a cross-sectional, observational, analytical study and has a quantitative approach. The research was carried out in a large general public hospital with 235 adults, aged 18 years and over, and with indication of peripheral intravenous access admitted to the surgical specialties unit. The sample size calculation was obtained based on the prevalence in literature of 53.9% difficult venous access, with 95% confidence and 6% margin of error. The data collection was performed through the application of an instrument during the direct observation of PIA. The project was approved by the Research Ethics Committee of the University Federal of the Triângulo Mineiro. The instrument variables were coded and cataloged in a dictionary (codebook). The data were double-digitized and validated in an Excel® Microsoft Office® worksheet and later analyzed in the IBM® Statistical Package for Social Sciences® version 20. The data were analyzed by descriptive statistic, inferential and by multiple binomial logistic regression for factors associated with the occurrence of difficult venous access. Results: It was verified that a majority of 156 (66.4%) were males, 138 (59,2%) white and 90 (39,1%) with 4 to 7 years of schooling. Regarding the clinical variables, the surgical specialty responsible for the most prevalent hospitalization was Urology with 65 (27%). Among adults with comorbidities, 94 (40%) had Systemic Arterial Hypertensionand 49 (20.9%) had Diabetes mellitus. The historical difficult venous access was reported by 53 (22.6%) of adults. The prevalence of difficult venous access was 77 (32.8%). The difficult venous access history (p = 0.001) and the non-visibility of the venous network (p = 0.03) were indicated as a predictor of difficult venous access occurrence. However, even though it was not statistically significant, the majority of the occurrence of difficult venous access was among female adults 31 (39.2%) with comorbidities 42 (35.9%) and the Body Mass Index changed 31 (31.6%). Discussion: The prevalence of difficult venous access is variable according to the individual's clinical variables. In the literature, values from 17% to 59.3% were identified. The identification of the factors associated with difficult venous access may lead to the elaboration of specific ducts and protocols for such cases, reducing the discomfort of the patient submitted to multiple punctures. Conclusion: The prevalence of difficult venous access was 32.8%. The history of difficult venous access and the non-visible venous network were indicated as predictors for difficult venous access.