The development of a risk score for unplanned removal of peripherally inserted central catheter in newborns1

Abstract

OBJECTIVE:

to develop a risk score for unplanned removal of peripherally inserted central catheter in newborns.

METHOD:

prospective cohort study conducted in a neonatal intensive care unit with newborn babies who underwent 524 catheter insertions. The clinical characteristics of the newborn, catheter insertion and intravenous therapy were tested as risk factors for the unplanned removal of catheters using bivariate analysis. The risk score was developed using logistic regression. Accuracy was internally validated based on the area under the Receiver Operating Characteristic curve.

RESULTS:

the risk score was made up of the following risk factors: transient metabolic disorders; previous insertion of catheter; use of a polyurethane double-lumen catheter; infusion of multiple intravenous solutions through a single-lumen catheter; and tip in a noncentral position. Newborns were classified into three categories of risk of unplanned removal: low (0 to 3 points), moderate (4 to 8 points), and high (≥ 9 points). Accuracy was 0.76.

CONCLUSION:

the adoption of evidence-based preventative strategies based on the classification and risk factors faced by the newborn is recommended to minimize the occurrence of unplanned removals.

Journal

Journal ID (nlm-ta): Rev Lat Am Enfermagem

Journal ID (iso-abbrev): Rev Lat Am Enfermagem

Title: Revista Latino-Americana de Enfermagem

Publisher: Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo

ISSN (Print): 0104-1169

ISSN (Electronic): 1518-8345

Publication date (Electronic): 03 July 2015

Publication date (Print): May-Jun 2015

Volume: 23

Issue: 3

Pages: 475-482

Affiliations

[2 ]Doctoral student, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil. RN, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil

[3 ]PhD, Professor, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil

[4 ]PhD, Associate Professor, School of Nursing, Duke University, Durham, NC, United States

[5 ]PhD, Professor, Escola de Enfermagem, Universidade Federal Fluminense, Rio de Janeiro, RJ, Brazil

[6 ]PhD, RN, Instituto da Criança, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil

Author notes

Corresponding Author: Priscila Costa Universidade de São Paulo. Escola de Enfermagem Av. Doutor Enéas de Carvalho Aguiar, 419 Bairro: Cerqueira César CEP: 05403-000, São Paulo, SP, Brasil E-mail: priscila2.costa@ 123456usp.br

Article

DOI: 10.1590/0104-1169.0491.2578

PMC ID: 4547071

PubMed ID: 26155011

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Page count

Figures: 3, Tables: 6, Equations: 0, References: 28, Pages: 1

Categories

Subject: Original Articles