Heparin solution for maintaining peripheral venous catheter patency in children: a survey of current practice in italian pediatric units

• Published in: Issues in comprehensive pediatric nursing Vol. 37; no. 2; pp. 122 - 135
• Main Authors: Bisogni, Sofia, Giusti, Francesca, Ciofi, Daniele, Festini, Filippo
• Format: Journal Article
• Language: English
• Published: England Informa Healthcare USA, Inc 01.06.2014; Taylor & Francis
• Subjects: Catheterization, Peripheral - nursing; Catheterization, Peripheral - statistics & numerical data; Child; Child, Preschool; Cross-Sectional Studies; Female; Heparin; Heparin - administration & dosage; Humans; Infant; Infant, Newborn; intravenous cannulation; Italy; Male; neonatal nursing; normal saline; Nurse's Role; Nursing; Nursing Evaluation Research; Nursing Methodology Research; pediatric nursing; Pediatric Nursing - methods; Pediatric Nursing - statistics & numerical data; periferal venous catheter; Practice Patterns, Nurses' - statistics & numerical data; Sodium Chloride - administration & dosage; Italy
• ISSN: 0146-0862; 1521-043X
• DOI: 10.3109/01460862.2014.895562

Background: Prolonging the duration of peripheral venous catheters (PVC) as long as possible in children is a nursing priority. However, available studies provide conflicting evidence on what kind of flush/lock solution should be used to increase the life of PVCs in children. Objectives: To describe the clinical behavior of nurses working in Italian pediatric units with regards to PVCs flushing and locking practices. Methods: Cross-sectional study. Nurses were invited to participate using the network of the Italian Society of Pediatric Nursing Science. Those participating completed an online questionnaire available on a website established for this specific purpose. Results: 405 questionnaires were completed. Results: The majority of nurses reported using Normal saline solution (NS) to flush 22 gauge PVCs: 77.6% in children up to 6 months of age, 74.7% in children 6 months to 2 years, and 74.6% in children over 2 years. Nurses tend to use heparin solutions (HS) more frequently when a smaller gauge PVC is used (24 instead of 22) and when access is less frequent. The use of HS for PVC lock is more common in onco-hematology units (54.5% in children over 6 months with 24 gauge PVC), pediatric surgery units (35%), and in short-stay units (55.6%), whereas NS is used more frequently in Intensive care units (9.4%) and neonatology units (12.2%). Conclusion: Although the majority of respondents use NS, we found a high variability in practices among Italian nurses. More research on the effectiveness and safety of HS in maintaining the patency of PVCs is needed.