Diagnostic accuracy of the Catheter Injection and Aspiration (CINAS) classification for assessing the function of totally implantable venous access devices

Purpose Intravenous catheters are used for the administration of intravenous therapy and for blood sampling. These devices are considered as well-functioning if both the injection and aspiration are easy. Malfunction is frequently observed and usually vaguely described as occlusion. We developed the...

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Bibliographic Details
Published in:	Supportive care in cancer Vol. 24; no. 2; pp. 755 - 761
Main Authors:	Goossens, G. A., De Waele, Y., Jérôme, M., Fieuws, S., Janssens, C., Stas, M., Moons, P.
Format:	Journal Article
Language:	English
Published:	Berlin/Heidelberg Springer Berlin Heidelberg 01-02-2016 Springer Springer Nature B.V
Subjects:	Aged Analysis Catheterization, Central Venous - classification Catheterization, Central Venous - methods Catheters Catheters, Indwelling - standards Classification Cross-Sectional Studies Female Health Care Service and Management, Health Policy and Services and Health Economy Humans Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi Male Medical equipment Medicine Medicine & Public Health Middle Aged Nurses Nursing Nursing Research Omvårdnad Oncology Original Article Pain Medicine Prospective Studies Prostheses and implants Rehabilitation Medicine CINAS Vascular access devices Malfunction Equipment failure Classification tool
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Summary:	Purpose Intravenous catheters are used for the administration of intravenous therapy and for blood sampling. These devices are considered as well-functioning if both the injection and aspiration are easy. Malfunction is frequently observed and usually vaguely described as occlusion. We developed the CINAS, the Catheter Injection and Aspiration scheme. The CINAS is a catheter function classification tool, which classifies both the injection and the aspiration ability in a uniform way. Each CINAS class consists of a combination of an injection (IN) and an aspiration (AS) code: e.g. IN1AS1 is the CINAS class for a well-functioning catheter. In this series, we aimed to determine the accuracy of the CINAS class reported by nurses, after minimal training, versus a trained researcher, acting as a reference standard. Methods Catheter function was assessed during a standard blood sampling procedure through a totally implantable venous access device in a convenience sample of 150 oncology patients. One nurse researcher and 111 oncology nurses both scored the catheter function according to the CINAS classification scheme, independently. Concordance between the scores was calculated. Results For the 140 catheters scored as well-functioning (IN1AS1 score) by the researcher, 139 or 99.3 % (95 % confidence interval (CI) 96.1–99.9 %) were scored correctly by the nurse participants. Nine out of ten or 90 % (95 % CI 55.5–98.3 %) of malfunctioning catheters (researcher scores different from IN1AS1) were also identified as malfunctioning by the nurse participants and received exactly the same CINAS score in eight cases (80 %, 95 % CI 44.4–97.5 %). The overall accuracy of the CINAS scored by the nurse participants versus the researcher is (139 + 9)/150 or 98.7 % (95 % CI 95.3–99.8 %). Conclusions Nurse participants were able to classify the catheter function of totally implantable venous access devices with the CINAS accurately after a brief explanation about the classification options.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0941-4355 1433-7339 1433-7339
DOI:	10.1007/s00520-015-2839-x