267 Peripherally-inserted central catheters use and care in cystic fibrosis: A survey on the practice of free-lance home care nurses in France

Abstract

Background A study conducted at Cochin Hospital in Paris showed that PICC lines were generally safe to infuse IV antibiotic courses at home for patients with Cystic Fibrosis (CF) and non-CF bronchiectasis (Burgel et al., 2014). However, in our CF centre, we have observed that dressing changes performed by free-lance nurses are oftentimes inadequate and inconsistent. In France, PICC lines have been used since 2005 and home care is provided by free-lance nurses who are responsible for their own training on PICC line care. Objectives To evaluate the skills and practice of free-lance nurses relating to PICC line care, particularly to identify the variables leading to improper PICC line dressing change. Methods A survey was conducted among free-lance nurses between March 2012 and January 2014. 296 self-administered questionnaires were filled by nurses at the beginning of IV therapy training sessions. Results 56.4% had already used a PICC line. 91.6% of them had changed the dressing at least once, 74.4% of which had changed the sutureless securement device (SSD) at least once (41.2% of the overall population). 41% found the SSD difficult to remove and to set up. 43.4% had been trained by private medical supply providers and 39.7% by hospital personnel. Nurses who had been trained were four times more likely to answer questions correctly and three times more likely to have the skills to follow practice guidelines. Conclusion This study enabled us to gain a better understanding of home care nursing practice, and to identify SSDs change as the main problem and therefore to tailor IV therapy training to the actual needs of free-lance nurses working in the home care setting.