“The Catheter is Occluded?” The Catheter Injection and Aspiration (CINAS) Classification Answers Your Question Accurately!

Abstract

Background A well-functioning intravenous catheter allows both easy injection and blood aspiration. Malfunction occurs when these procedures are difficult and/or impossible. Since malfunction is often vaguely described, misunderstandings may arise between healthcare providers. Consequently, the real problem remains uncertain and this may lead to erroneous prescription of thrombolytic drugs and to inadequate reports on functional outcomes. Purpose The heterogeneity in catheter function description led to the development of the CINAS classification tool. The CINAS is the first tool able to describe completely the catheter function based on assessment of both injection and aspiration abilities. It consists of nine scoring options combining three categories of functional outcome (1=easy; 2=difficult; 3=impossible). Project description We tested the validity and accuracy of the CINAS. First, all functional problems (n=3950) in all types of catheters for which an Advanced Practice Nursing team was consulted in our hospital over a five year period were classified along the CINAS. In a second phase, 111 nurses who were briefly informed about this classification, assessed implantable ports function of 150 patients during their daily practice. Their scoring results were compared to those of a reference standard to assess the accuracy. Results In 35 among 3950 malfunction events (1%), catheter function could not be classified. Therefore we added a fourth category “unspecified” to the CINAS. Nurses were able to use the CINAS for 150 port catheter function assessments. They scored in 99% correctly a well-functioning catheter and in 80% a malfunction into the correct malfunction class. Implications The CINAS is able to describe completely every catheter function assessment in clinical practice and for research purposes. In electronic patient records, malfunction management protocols may be linked to the different CINAS classes. Conclusions The CINAS classification is simple, clear, cheap and helps healthcare workers to document accurately the catheter function.status: publishe