Holding and Mobility of Pediatric Patients With Transthoracic Intracardiac Catheters.
Amy Jo Lisanti, Stephanie Helman, Andrea Sorbello and 4 others
PMID 32737488WHAT IT FOUND
After new catheter dressing, securement, and mobility guidelines, pediatric cardiac ICU patients with transthoracic intracardiac catheters were documented out of bed more often and on more days.
Three catheters shifted internally after mobilization, but none needed major treatment.
Key findings
01After the new TIC policies and procedures were initiated, out-of-bed documentation increased over time and patients experienced significantly more days out-of-bed.
02Three patients had internal malposition of their TICs within 12 hours of mobilization.
03No mobilized patients required chest re-exploration, blood transfusions, or other major interventions, and no catheters were dislodged at the skin or cracked.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This was a single pediatric cardiac ICU quality improvement project, so results may not generalize to other units. Adverse event data were based on staff self-report only, so unreported dislodgments cannot be excluded. The team did not track complication rates or adverse events associated with TICs before the new policies, so overall complication rates over time cannot be determined. Individual patients varied widely. Most patients with TICs were documented out-of-bed less than 20% of their postoperative days, although some reached 90%. The new securement guidelines were not followed in all three internal malposition cases, so the project cannot separate policy effects from practice fidelity.
The easy way to misread this
Do not conclude that mobilization caused the three internal malpositions. In all three cases securement was not performed according to the new guidelines, no catheter was dislodged at the skin or cracked, and internal malposition is a known complication even in patients on bedrest.