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Background: During the COVID619 pandemic, hospitals implemented several infection control measures that could affect the quality of insertion and management of peripheral intravenous catheters $PIVCs). Pre-pandemic studies found a high rate of PIVC complications, but no studies to date have assessed the quality during the pandemic period. Objective: This prospective study aimed to investigate the effect of the pandemic on PIVC management and care. Method: Data were collected from adult patients $_18 years) at a university hospital in Norway during a three-week period in February 2020 (pre-pandemic: PP group) and a three-week period in October 2020 (pandemic: P group). The primary outcome measure was PIVC quality as determined by the validated PIVC Mini Questionnaire $PIVC-miniQ%, which consists of 16 items relating to deviations from best practice. Results: The study included 483 PIVCs and 413 patients. Of these, 238 PIVCs $49.3%% were collected in the PP group and 245 $50.7%% in the P group. In the PP group, 41.8% of the PIVCs were 18 gauge (green PIVC% or larger, compared to 53.3% in the P group. The median PIVC-miniQ score was 2 in both groups, with a range of 0710 in the PP group and 078 in the P group. Improved quality in terms of fewer patients reporting pain was registered in the P group $14.3% compared to 6.7%%, and 36.3% had blood in the IV line in the PP group, compared to 26.5% in the P group. However, a poorer quality was observed in the P group for the PIVC-miniQ items 'purulence' $0% in the PP group compared to 6% in the P group) and 'loose dressing' $15.2% in the PP group compared to 24.9% in the P group). Documentation of PIVC insertion and indication was equally insufficient in both groups (p = 0.857%. Conclusion: Although some differences were observed at item level, the PIVC quality as measured by the PIVC-miniQ total score remained unchanged during the pandemic. Given the low workload of our hospital during the pandemic, it is a paradox that the PIVC care did not improve. [ABSTRACT FROM AUTHOR]

Aims: Intravenous amiodarone is an irritant of peripheral blood vessels with phlebitis as an adverse effect. The aims were to determine the incidence of intravenous amiodarone-induced phlebitis, to describe adherence to a clinical practice guideline, and to determine how characteristics were distributed between those with and without phlebitis. Methods and results: A prospective observational study was conducted. Adult patients treated with amiodarone through a peripheral intravenous catheter (PIVC) or a central venous catheter were included. PIVC characteristics were measured using the PIVC mini questionnaire. Patients with ≥two signs of phlebitis were categorized as having phlebitis. Adherence to the clinical practice guideline was registered on a standard abstract sheet. Data were collected from the amiodarone start-up to 2 days after the amiodarone was discontinued. In total, 124 patients with amiodarone infusions were observed, of which 69% were administered via a PIVC. The phlebitis rate was 44%. Fifty-three per cent developed amiodarone-induced phlebitis during the infusion phase, while 47% presented phlebitis during the post-infusion phase. The three most observed signs or symptoms of phlebitis were redness (87%), pain (81%), and swelling (71%). The most commonly used PIVC site was the elbow, and 35% of the PIVCs were large (18 gauge), which was the last preferred site and size according to the clinical practice guideline. Conclusion: A large proportion of the patients developed amiodarone-induced phlebitis. The adherence to the clinical practice guideline was not optimal according to the PIVC recommendations. Prevention of amiodarone-induced phlebitis should have high priority to reduce patient harm. Graphical Abstract [ABSTRACT FROM AUTHOR]

Background: Total knee arthroplasty is experienced as a painful procedure, and pain after surgery seems to be the most limiting factor for early mobilisation. Physical exercise is of utter importance for avoiding complications such as persistent pain and functional limitations. A fast‐track pathway aims at improving patient outcome, and patients are now discharged 2–3 days after surgery. Little is known about how the patients cope with pain, exercise or daily activities at home. Aim: To explore the experience of patients undergoing total knee arthroplasty in a fast‐track pathway during the first 2 weeks after surgery. Design: Qualitative design. Methods: Three focus group interviews, including 13 patients from two different units of an orthopaedic department in central Norway, were conducted from May to June 2015. The interviews were analysed using Malteruds` method of systematic text condensation. Findings: The main finding was the patients' determination and ability to cope at home. The fast‐track pathway seemed to enable patients to take an active role in own self‐care. The patient's coping capacity was strengthened by education, knowledge and predictability. Four main areas related to coping emerged after discharge. First, the majority of patients expressed that it was good to come home and take responsibility for their own rehabilitation. Second, prerequisites for feeling secure after returning home were highlighted. Third, the patients seemed empowered by sharing experiences with others. Fourth, postoperative pain was prevalent in many patients after discharge, but the patients seemed prepared by information provided in the fast‐track pathway. Conclusion: The fast‐track pathway released coping skills and resources among the patients. The expectation of, and preparation for early discharge made the patients feel confident when discharged few days after surgery. The patients expected to take great responsibility for their own rehabilitation process. [ABSTRACT FROM AUTHOR]

Background: Most patients in Norwegian hospitals are routinely given one or more peripheral venous catheters. A peripheral venous catheter is considered to be a benign device but may entail a risk of local infection with resulting bloodstream infection and sepsis. Good practice in the insertion and care of these catheters is essential to prevent infection., Material and Method: This study presents Norwegian data from the 'One Million Global Catheters Study', which evaluated practice in relation to peripheral venous catheters in 419 hospitals in 51 countries. Two Norwegian hospitals collected data from medical and surgical wards on a single day in November 2014 (Levanger Hospital) and a single day in February 2015 (St Olavs Hospital). Professional development nursing specialists recorded observations of peripheral venous catheters such as insertion site, dressing, documentation and indication., Results: We evaluated 136 peripheral venous catheters in a total of 121 patients. We found 44 (32.4 %) catheters associated with various clinical problems such as pain, redness or swelling around the insertion site, catheter dislocation, or blood in the infusion set. Altogether 50 peripheral venous catheters (36.8 %) were not in use for either medications or fluid on the day in question. In 93 of 131 cases (71.0 %), there was no documentation of venous catheter assessment in the previous 24 hours., Interpretation: Care and monitoring of venous catheters could be significantly improved. There was considerable incidence of unused peripheral venous catheters, and lack of documentation was widespread.