Systematic evaluation and re-evaluation of influencing factors on the effectiveness and safety of venous catheterization in hospitalized children
LIU Yi
CUI Wenxiang
Abstract：Objective:To explore the influencing factors of the effectiveness and safety of intravenous catheterization in children through systematic evaluation and re-evaluation,and provide references for clinical nursing workers.Methods:Systematic review and Meta analysis of literature on venous catheterization in hospitalized children was conducted on CNKI,WanFang Database,VIP Database,CBM,Web of Science,PubMed,MedLine,EBSCO,the Cochrane Library.The retrieval time was from January 2011 to October 2022.AMSTAR tool was used to evaluate the methodological quality of the included study,PRISMA tool was used to evaluate the quality of the included study report,and GRADE evidence grading was used to evaluate the outcome indicators.Results:14 systematic evaluations/Meta-analysis were ultimately included,with an average overall report quality score of 23.6 points,indicating high quality;the GRADE evidence level evaluation includes 1 high-quality literature,7 medium quality literature,5 low quality literature,and 2 extremely low quality literature;the Kappa consistency value was 0.903.The Meta-analysis results showed that catheter associated bloodstream infection(OR=0.189,95％CI 0.034-0.343,Z=2.40,P=0.017);the mortality rate(OR=0.440,95％CI 0.053-0.827,Z=2.23,P=0.026)showed statistically significant differences.Qualitative analysis results showed that risk factors for neonatal PICC infection included placental abruption,body mass≤1 500 g,gestational age≤37 weeks,respiratory distress,Apgar≤7 points,history of catheter occlusion,and ward catheterization;the protective factors for neonatal PICC related infections include puncture duration≤30 minutes,puncture frequency＜2 times,and catheter retention time≤7 minutes.Conclusion:The overall quality of inclusion in the system evaluation/Meta-analysis is of medium quality,the quality of reporting is of high quality,and the quality of evidence for outcome indicators is of medium or low quality.Placental abruption,body mass≤1 500 g,gestational age≤37 weeks,respiratory distress,Apgar≤ 7 points,history of catheter occlusion,and ward catheterization are risk factors for neonatal PICC related infections;the protective factors for neonatal PICC related infections are puncture duration≤30 minutes,puncture frequency＜2 times,and catheter retention time≤7 minutes.
Keywords：peripherally inserted central cathetercentral venous catheterperipheral venous cathetereffectivenesssafetyinfluencing factorssystem evaluation and re-evaluationevidence-based nursing
Publication Date：2023-12-31
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 4415-4422 )