English title dissertation Managing the complications of intravenous devices in the neonatal intensive care unit: a contribution to patient safety
Name PhD (surname first) Arnts I.J.J.
Doctor is (has been) nurse
Date of promotion 23/09/2015
University Radboud Universiteit Nijmegen
Promotores Prof. dr R. de Groot, Dr. K. Liem
Abstract (English)

All critically ill newborns (gestational age 24-42 weeks) need intravenous devices as peripheral intravenous locks (IVLs), umbilical venous catheters (UVCs) and periferally inserted central venous catheters (PICCs ) for administration of medication or total parenteral nutrition. These catheters are not without risks.
We analysed that saline can be used for flushing the IVLs instead of heparin solution. Central line associated bloodstream infection (CLABSI) is the most common complication in UVCs and PICCs. Prone position (improve the respiration) with an indwelling UVC did not show a clear increase of complications and is relatively safe. The introduction of a CLABSI bundle reduced CLABSI significantly in PICCs unlike to UVCs. The change in insertion set and the difference in involvement and experience of the group inserters of the UVCs unlike to the PICCs can be the reasons for this difference.
Structural training programs for neonatal caregivers, daily evaluation of necessity of indwelling catheters, simple CLABSI bundles as a standard care and sharing complication outcomes of the catheters with the neonatal caregivers increase the personal awareness in reducing CLABSI.

Download dissertation (English) Proefschrift-Inge-Arnts-Managing-the-complications-of-intravenous-device.pdf