When a child needs peripheral i.v. therapy.
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Biomedical subjects
Publications and source records attributed to A M Frey.
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Interest in the immune response has greatly increased, mostly because of the discovery of the AIDS virus. An understanding of the basic function of the normal human immune system is vital knowledge for today's nurse. Part 1 of this article describes normal immune response as well as abnormal immune system function, and correlates this information with the clinical picture of the patient.
Part I of this article, published in the September/October 1991 issue of the Journal of Intravenous Nursing, reviews normal immune function, immune disorders, and diagnosis. The main treatment modality discussed in Part II is therapy with immune globulin IgG. History, indications, administration technique, and nursing care are highlighted.
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Data were collected on all peripherally inserted central catheters (PICCs) inserted by one i.v. nurse clinician from July, 1989 to June, 1992 in an urban pediatric teaching hospital of more than 100 beds. Growth of this PICC program, as well as outcome of patients with PICCs, was recorded and compared to published reports. During the surveillance period, 269 PICCs were successfully inserted in 226 patients out of 330 patients referred for PICC placement. This article contains the outcome of that program. Catheter duration and rate of PICC complication at St. Christopher's Hospital for Children (Philadelphia, Pennsylvania) was comparable to eight other published reports. PICCs are an efficacious and safe method of i.v. access for intermediate to long-term use in children.
Although many publications have demonstrated the cost-effectiveness of using i.v. nurse specialists with adult patients, very few have explored this topic in the pediatric population. Many agencies choose to use staff RNs and physicians, with minimal training and experience, to place i.v.s in both pediatric and adult patients. This article demonstrates i.v. insertion success rates for various healthcare providers: staff RNs, physicians, and an i.v. nurse specialist in an urban pediatric hospital. The number of unsuccessful i.v. attempts for each group is calculated and further applied to costs of labor and equipment. From the data presented in this article, it may be concluded that the use of one or more i.v. specialist nurses for placement of peripheral i.v.s in children is more cost effective than using staff RNs or physicians for provision of this service. These data were collected while the author was the i.v. nurse clinician at St. Christopher's Hospital for Children in Philadelphia.