Becton, Dickinson and Company · NYSE:BDX
Becton, Dickinson and — Technical Presentation (April 2020)
26 slides from Becton, Dickinson and's technical presentation, April 2020
Slide 1: Presentation disclaimer
These presentations were developed by the respective presenter(s), and the findings, interpretations, and conclusions contained or expressed with them do not necessarily reflect the views of BD. To the extent these presentations relate to specific products, such products should always be used in acc
Slide 2: Tracking complications and adverse events
Tracking complications and adverse events Fulvio Pinelli, MD Careggi University Hospital Florence, Italy
Slide 3: Dimension of the problem
Dimension of the problem •6 million CVC inserted in US per year •Over 15 million catheter days in US ICU alone Young P. UpToDate 2019
Slide 4: Types and Impact of VADs Complications
Types and Impact of VADs Complications • Occlusion (38%) - CVAD failure - Treatment disruption • Catheter related thrombosis (CRT) - 2-15% - Increased risk of PE (0-15%, depending on the location of CRT) • Venipuncture related (33%) - Pneumothorax, hemothorax, multiple attempt, nerve/artery damage,
Slide 5: Strategies To Reduce VADs Complications
Strategies To Reduce VADs Complications • INTERNATIONAL GUIDELINES • NATIONAL GUIDELINES • LOCAL PROTOCOLS • BUNDLES • CHECKLISTS • AUDIT, M&M • …..
Slide 6: Do we track complications?
Do we track complications? These strategies are not sufficient without an effective and continuous monitoring TRACKING COMPLICATIONS 5
Slide 7: Which VADs Complications are Monitored?
Which VADs Complications are Monitored? • Hospital Infection Team • Healthcare Associated Infections, every 6 months -37% Bacteremia -35% CLABSI (CICCs)
Slide 8: Limited informations, especially as vascular access specialists
Limited informations, especially as vascular access specialists… • Non-bacteremial complications: - venipuncture related, pocket infections, malpositioning, thrombosis, thrombophlebitis, displacement, malpositioning, failure, obstruction, etc..) • Other VADs? - Medium and Long term VADs; PIVs; etc..
Slide 9: We Needed More…An IT Tool Able To:
We Needed More…An IT Tool Able To: ❖Track ALL major complications ❖Dynamic and user friendly data manipulation ✓(research, surveys, statistics) ❖Process analyses ✓Benchmarking ✓Proficiency ✓Feedbacks and corrections in behaviuors ❖Application of insertion and maintanance bundle (checklist) ❖Decision
Slide 10: We had to start somewhere!
We had to start somewhere!
Slide 11: REDCap
REDCap Research Electronic Data Capture
Slide 12: What is it?
What is it? The REDCapTM (Research Electronic Data Capture) database is a registry adopted by Careggi University Hospital of Florence, Italy, and developed by Vanderbilt University. To date the software is used 131 countries, 3676 institutions and is cited 7093 scientific articles, becoming one of t
Slide 13: Clinical research has been changing
Clinical research has been changing Direct demonstration RCTs Refined inclusion criteria and patients’ selection a priori Effectiveness, Quality, Safety of Treatment Registry Real-life observation and outcomes analysis Indirect suggestion
Slide 14: Center-specific Precision Medicine
Center-specific Precision Medicine Customizing treatment to specific center and sub-populations of patients Center-specific Center-specific outcomes measures outcomes measure Start Change in Further practice improvements… Medium and Local Policies Long-term Local Practices, etc. feedbacks
Slide 15: Centro Accessi Vascolari Database
2 July 2019 Centro Accessi Vascolari Database Careggi University Hospital Florence, Italy
Slide 16: Platform Homepage
Platform Homepage Demographics Procedure Intraop Complications Late Complications Device Management Removal
Slide 17: Type of activity, device, population, etc…
Type of activity, device, population, etc… 16
Slide 18: Example: Early complications
Example: Early complications • 61 (6,4 %) cases over 988 • Repeated puncture: 27 • Arterial puncture: 3 • Hematoma in venipuncture: 6 • Tip navigation / location failed: 5 • PNX: 0 • Pocket bleeding: 7 17
Slide 19: Example: Late complications
Example: Late complications 95/958 (9,91 %) • Median days: 18 • Occlusion of the lumen: 6 • Reversible: 4 • Irreversible: 2 • CRT: 9 (8 symptomatic cases and 1 asymptomatic) • Mechanical complication: 18 • CRBSI: 3 18
Slide 20: Immediate complication check
Immediate complication check 19
Slide 21: More important: clinician/registry interaction
More important: clinician/registry interaction LOCAL INFECTION The system will help you in defining the complication, the SISTEMIC INFECTION severity and the further treatment strategy, using CLABSI bundles, reminders, suggestions as a decision support tool. CRBSI
Slide 22: Management
Management Maintanance STANDARDIZATION, HELPING DIAGNOSIS
Slide 23: Decision support
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Slide 24: Conclusion
CONCLUSION 1 •VADs complications have a considerable impact in terms of morbidity, mortality and costs •Tracking is fundamental part of a strategy of complication reduction
Slide 25: Conclusion 2
CONCLUSION 2 • IT technology may not only helping us in tracking complications. The platform-physician interaction has additional useful effects on the single utilizing center: - Renewal of the concept of “clinical research”, which is focused to tailoring and customizing clinical choices (center spe
Slide 26: Thank you
THANK YOU Fulvio Pinelli, MD Careggi University Hospital Florence, Italy
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