Construction and validation of a checklist for the management of totally implanted catheters in children

Souza, Giselle Vieira de; Souza, Isabella Pavarine de; Silva, Maria Paula Custodio; Toffano, Silmara Elaine Malaguti; Contim, Divanice

doi:10.1590/0034-7167-2023-0447

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 77 (4) • 2024 • https://doi.org/10.1590/0034-7167-2023-0447 copy

Construction and validation of a checklist for the management of totally implanted catheters in children

Construcción y validación de una lista de verificación para el manejo del catéter totalmente implantado en niños

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives:

to construct and validate the content of a checklist for the management of totally implanted catheters in hospitalized children and adolescents.

Methods:

methodological research conducted from October 2021 to December 2022 in two stages: development of the instrument with care guidelines and content validation of the checklist. The instrument, containing 23 items presented in Likert format, was evaluated online by specialists in two rounds. The Content Validity Index was applied, considering indices above 0.8 as valid.

Results:

the final checklist included four domains and 22 checklist items, validated with a Content Validity Index of 0.98. The overall evaluation of the instrument presented a global score of 9.9.

Conclusions:

the validation and application of instruments that standardize procedures, in addition to supporting professionals, promote autonomy and quality of care for children and adolescents using this device.

Descriptors:
Nursing Care; Validation Study; Vascular Access Devices; Pediatric Nursing; Checklist

Management of Totally Implanted Catheter in Hospitalized Children	CVI
Pre-procedure
1. Verify patient identification. Check name and ID number.	1.00
2. Explain the procedure to the patient and caregiver.	1.00
3. Sanitize hands with soap and water or 70% alcohol gel using aseptic technique.	1.00
4. Gather materials and place them on a mobile utility table near the patient’s bed.	1.00
5. Sanitize hands with 2% chlorhexidine scrub or an alcohol-based preparation recommended by the institution.	0.97
6. Don personal protective equipment (cap, surgical mask for both professional and patient, disposable gown, and sterile gloves).	0.91
Procedure - Puncture
7. Perform antisepsis of the reservoir with 0.5% to 2% alcoholic chlorhexidine, using sterile gauze and forceps, in a Z-technique, for 30 seconds. (Repeat 3 times)	0.89
8. Wait until the alcohol solution evaporates from the skin, or dry with sterile gauze.	0.89
9. Place a fenestrated drape or sterile compress at the puncture site.	1.00
10. Stabilize the catheter reservoir between the thumb and index finger of the non-dominant hand.	1.00
11. Puncture the central region of the reservoir, gently inserting the Huber needle at a 90° angle until it touches the bottom.	1.00
12. Aspirate using a 10 ml syringe to withdraw about 2 ml of the solution from the reservoir or until blood reflux is observed.	1.00
13. Test the catheter’s patency. Infuse 10 ml of 0.9% saline solution using a turbulence technique. Clamp the extension after confirming patency.	1.00
Post-procedure
14. Apply an occlusive dressing with sterile polyurethane transparent film or sterile gauze and adhesive tape.	1.00
15. Change the dressing according to the type of covering used. For sterilized transparent polyurethane film, change every 7 days. For dressing with sterile gauze and adhesive tape, change within 48 hours. Change immediately if the dressing is loose, wet, or soiled.	1.00
16. Label the dressing with the type and gauge of the needle used, date, time, and name of the nurse who performed the puncture.	1.00
17. Record the procedure in the patient’s medical chart.	1.00
Maintenance
18. Always use a 10 ml or larger syringe for catheter manipulation.	1.00
19. Disinfect the connectors before each access or manipulation with an alcohol-based antiseptic solution, applying friction for 5 to 15 seconds.	1.00
20. Maintain the Huber needle for up to seven days, protected by a sterile covering.	0.89
21. Perform heparinization or salinization after the end of use or every 30 days if the catheter is not in use.	1.00
22. When removing the puncture, use 2 ml of the solution (0.2 ml of heparin 5000 IU/ml + 9.8 ml of 0.9% saline) for HEPARINIZATION or 10 ml of 0.9% saline for SALINIZATION using a turbulence technique and then proceed with the removal ofthe needle from the reservoir.	1.00

Evaluated Items	Average
Usefulness/Relevance	9.9
Consistency	10
Clarity	9.9
Objectivity	10
Simplicity	9.9
Feasibility	10
Up-to-date Information	9.9
Accuracy	9.9
Instructional Sequence of Topics	9.9
Presentation Format of the Protocol	9.9
Global Evaluation	9.9

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:
Divanice Contim, E-mail: d.contim@uol.com.br