Acceso venoso periférico utilizando dispositivos de aguja con y sin extensión: costos y resultados

Lima, Antônio Fernandes Costa; Saba, Amanda; Neves Filho, Abílio Gonçalves das; Couto, Karen Aparecida; Silva, Luciana Oliveira e

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 73 (5) • 2020 • https://doi.org/10.1590/0034-7167-2018-0921 copiar

Acceso venoso periférico utilizando dispositivos de aguja con y sin extensión: costos y resultados

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivos:

analizar el costo directo promedio y los resultados de permanencia del acceso venoso periférico, utilizando dispositivos de aguja con y sin extensión.

Métodos:

investigación cuantitativa, exploratoria descriptiva. Se siguieron los pinchazos venosos y el tiempo de permanencia de los dispositivos. El costo directo promedio se calculó multiplicando el tiempo (cronometrado) dedicado por los profesionales de enfermería por el costo unitario de la mano de obra, lo que se suma al costo de los materiales.

Resultados:

el costo directo promedio total de usar dispositivos “extendidos” (US$ 9,37) fue 2,9 veces el costo de usar dispositivos “no extendidos” (US$ 4,50) de materiales, US$ 7.71 y US$ 2.66, respectivamente. Con un total de 96 horas de estadía, el “dispositivo de aguja extendida” mostró una menor ocurrencia de pérdida accidental.

Conclusiones:

a pesar del costo directo promedio más alto, el uso de un “dispositivo de aguja extendida” fue más efectivo para favorecer un tiempo de acceso venoso periférico adecuado.

Descriptores:
Dispositivos de Acceso Vascular; Enfermería Médico-Quirúrgica; Cuidado de Enfermería; Costos y Análisis de Costos; Control de Costos

Variables	Device over needle		p value^† † p value - Chi-square test
	With extension	Without extension
	n= 64	n= 64
Diagnosis
Cardiac insufficiency	6	6	1.000
Hypertension	25	23	0.855
Systemic lupus erythematosus	4	6	0.744
Dyslipidemia	4	6	0.744
Diabetes Mellitus	17	20	0.697
Encephalopathy	4	2	0.680
Pneumonia	2	4	0.680
Chronic Kidney Disease	9	12	0.634
Stroke	1	3	0.619
Pleural effusion	2	0	0.496
Infection	8	4	0.364
Anemia	12	7	0.320
Chronic obstructive pulmonary disease	1	5	0.208
Cirrhosis	3	8	0.206
Acute Kidney Failure	4	0	0.119
Indication for PVA installation^* * PVA - peripheral venous access;
Painkiller administration	18	22	0.568
Electrolyte replacement	7	11	0.446
Hemotherapy administration	5	2	0.440
Antibiotic administration	22	27	0.467
Diuretic administration	12	7	0.223
Puncture attempt
01 attempt	54	43	0.038
02 attempt	10	19	0.143
03 attempt	0	2	0.496

Groups	Device over needle with extension				Device over needle without extension				p value^† † US$ - US$ conversion rate corresponding to US$ 0.31/R$, based on the quotation of July 29, 2016, provided by the Central Bank of Brazil; ‡ p value - Mann-Whitney test, p <0.005
Observations	Mean US$^† † US$ - US$ conversion rate corresponding to US$ 0.31/R$, based on the quotation of July 29, 2016, provided by the Central Bank of Brazil; ‡ p value - Mann-Whitney test, p <0.005	Standard Deviation US$^† † US$ - US$ conversion rate corresponding to US$ 0.31/R$, based on the quotation of July 29, 2016, provided by the Central Bank of Brazil; ‡ p value - Mann-Whitney test, p <0.005	Minimum US$^† † US$ - US$ conversion rate corresponding to US$ 0.31/R$, based on the quotation of July 29, 2016, provided by the Central Bank of Brazil; ‡ p value - Mann-Whitney test, p <0.005	Maximum US$^† † US$ - US$ conversion rate corresponding to US$ 0.31/R$, based on the quotation of July 29, 2016, provided by the Central Bank of Brazil; ‡ p value - Mann-Whitney test, p <0.005	Mean US$^† † US$ - US$ conversion rate corresponding to US$ 0.31/R$, based on the quotation of July 29, 2016, provided by the Central Bank of Brazil; ‡ p value - Mann-Whitney test, p <0.005	Standard Deviation US$^† † US$ - US$ conversion rate corresponding to US$ 0.31/R$, based on the quotation of July 29, 2016, provided by the Central Bank of Brazil; ‡ p value - Mann-Whitney test, p <0.005	Minimum US$^† † US$ - US$ conversion rate corresponding to US$ 0.31/R$, based on the quotation of July 29, 2016, provided by the Central Bank of Brazil; ‡ p value - Mann-Whitney test, p <0.005	Maximum US$^† † US$ - US$ conversion rate corresponding to US$ 0.31/R$, based on the quotation of July 29, 2016, provided by the Central Bank of Brazil; ‡ p value - Mann-Whitney test, p <0.005
Cost of direct labor of nursing professionals (US$ ^† † US$ - US$ conversion rate corresponding to US$ 0.31/R$, based on the quotation of July 29, 2016, provided by the Central Bank of Brazil; ‡ p value - Mann-Whitney test, p <0.005 )	1.66	0.82	0.71	5.32	1.84	0.92	0.92	5.23	0.31
Material cost (US$ ^† † US$ - US$ conversion rate corresponding to US$ 0.31/R$, based on the quotation of July 29, 2016, provided by the Central Bank of Brazil; ‡ p value - Mann-Whitney test, p <0.005 )	7.71	2.28	6.67	13.80	2.66	0.74	1.71	4.29	<0.001
Total mean direct cost (US$ ^† † US$ - US$ conversion rate corresponding to US$ 0.31/R$, based on the quotation of July 29, 2016, provided by the Central Bank of Brazil; ‡ p value - Mann-Whitney test, p <0.005 )	9.37	2.79	7.38	19.12	4.50	1.29	2.74	8.99	<0.001

Clinical outcomes	Device over needles		p value^†
Clinical outcomes	With extension	Without extension	p value^†
First day	n=64	n=64
Absence of phlogistic signs	63	56	0.03
Pain	0	4	0.11
Accidental loss	1	4	0.36
Second day	n=63	n=56
Absence of phlogistic signs	50	51	0.82
Pain	5	0	0.05
Extravasation	1	1	1.00
Phlebitis	0	1	1.00
Accidental loss	1	2	1.00
End of therapy	6	1	0.20
Third day	n=50	n=51
Absence of phlogistic signs	45	41	0.57
Phlebitis	0	2	0.49
Accidental loss	0	4	0.11
End of therapy	5	4	0.71
Fourth day	n=45	n=41
Absence of phlogistic signs	43	36	0.27
Pain	1	1	1.00
Accidental loss	1	3	0.61
End of therapy	0	1	1.00
Everyday (96 hours)	n=64	n=64
Absence of phlogistic signs	43	36	0.27
Pain	6	5	1.00
Extravasation	1	1	1.00
Phlebitis	0	3	0.24
Accidental loss	3	13	0.01
End of therapy	11	6	0.27

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
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[1] Corresponding author: Antônio Fernandes Costa Lima. E-mail: tonifer@usp.br