A qualitative study of factors influencing evidence-based practice of blood collection by clinical nurses via central venous access devices.

Abstract

Several studies have upheld the advantages of blood collection using via central venous access device (CVAD); the procedure has a high success rate and avoids painful repeated punctures. Some studies have suggested that via central venous access device (CVAD) blood collection is preferable for acute and critical care, oncology, and pediatric patients. However, there is no consensus on or standardization of this approach. To explore the facilitators of and barriers factors of evidence-based decision-making in CVAD blood collection in clinical practice. This was a qualitative study guided by phenomenological research. A purposive sampling method was used to select 13 clinical nurses from two public hospitals in China to conduct semi-structured personal interviews. The interview outline was designed based on a literature review and the i-PARIHS theoretical framework, and information was organized and analyzed using the Colaizzi 7-step analysis method. Two themes and seven sub-themes were derived from the analysis of interview data. Facilitating factors: (1) nurses' trust the evidence-based nursing decisions; (2) low rate of operational complications; (3) high success rate of blood collection; (4) nurses' sense of professional benefit; Hindering factors: (1) preparation of operational materials and time-consuming operation; (2) nursing interruptions; (3) patients' economic factors. The interview data showed that CVAD blood collection is suitable for critically ill patients, children, patients with poor venous conditions and poor cooperation. This study provides guidance for advancing the clinical application of evidence-based CVAD blood collection. Evidence-based nursing culture, operational advantages, and nurses' sense of professional benefit were effective facilitators of the evidence-based practice. Researchers need to optimize the operating materials and methods, and comprehensively consider multiple factors to promote the better application of evidence.