Nurses have been frustrated by patency loss in their patients' PIIDs for many years.
The results of this study are similar to those of Danek and Noris (1992) and Gyr and colleagues (1995) who demonstrated that 24-gauge PIIDs flushed with heparin lasted longer than those flushed with normal saline.
Although conclusions provide insight into the patency of 24-gauge PIIDs, limitations of this study include: non-randomized study design, multiple catheter use per patient, and absence of validation of RN's assessment of the IV sites.
In an effort to contain cost and maintain quality of care and patient satisfaction, nurses must be knowledgeable about the most effective and efficient way to care for patients with PIIDs.
It demonstrated that heparin flush is more effective and associated with fewer problems than normal saline for maintaining patency of 24-gauge PIIDs. Based on the results of this study, we conclude that heparin flush solution should be used for hospitalized children requiring the use of 24-gauge PIIDs.
McMullen, Fioravanti, Pollack, Rideout, and Sciera (1993) compared the efficacy of heparin and saline used to maintain PIID patency in a sample of patients ranging in age from birth to 18 years.
Reasons for use of the PIID included the administration of medications, blood products, hyperalimentation, lipids and fluids, and for emergency treatment.
Catheter duration was calculated from the time the catheter was inserted or converted to a PIID to the time the catheter was removed or converted to a continuous infusion.
Based on Chi-square analysis, there was no significant difference between the groups for factors such as: age of patient ([is greater than] 30 days vs [is less than] 30 days), catheter placement site, irritating substances infused, and whether the catheter was started as a continuous infusion prior to conversion to a PIID (see Table 1).