Abstract
Background: Peripheral intravenous catheter (PIVC) insertion and maintenance are the procedures most commonly performed by nurses in clinical settings. However, current catheter failure rates are high, thus compromising the patient’s therapeutic plan and well-being. Objective: To understand nurses’ practices during PIVC insertion and maintenance. Methodology: A transversal and descriptive study was conducted in a cardiology ward in central Portugal. Nurses’ (n = 26) practices during PIVC management were observed and recorded by a research nurse during the morning shift, using a checklist based on transnational standard of care (SoC) recommendations. Results: During PIVC insertion (n = 38) the main digressive areas included glove usage (55.2%), use of the aseptic non-touch technique (44.7%), hand hygiene (18.4%-84.2%), and patient education (28.9%). Regarding PIVC maintenance (n = 66), catheter hub disinfection (78.8%), catheter flushing (53.3%- 78.8%), and patient education (24.2%) were the main deviating areas found. Significant PIVC failure rates were found (25.8%). Conclusion: Overall, a substantial number of PIVC-related practices does not comply with current SoC recommendations, which may pose a risk to patient safety and care quality
Highlights
In a progressively challenging clinical environment, the quality and safety of healthcare depend on integrating the best evidence in regular nursing practice (Ray-Barruel & Rickard, 2018)
This reality gains new implications when discussing the need for inserting a peripheral intravenous catheter (PIVC) during hospitalization, since the majority of patients worldwide requires at least one to fulfill the prescribed therapeutic plan (Alexandrou et al, 2018)
A significant number of authors highlighted that the professional practices observed do not always comply with the recommended standards of care (SoC) in this thematic area (Bernatchez, 2014; Braga et al, 2018; Fiorini et al, 2018; Kampf et al, 2013), such as the guidelines from the Centers for Disease Control and Prevention (CDC; O’Grady et al, 2011), the Royal College of Nursing (RCN, 2016), and the Infusion Nurses Society (INS, 2016)
Summary
In a progressively challenging clinical environment, the quality and safety of healthcare depend on integrating the best evidence in regular nursing practice (Ray-Barruel & Rickard, 2018). A significant number of authors highlighted that the professional practices observed do not always comply with the recommended standards of care (SoC) in this thematic area (Bernatchez, 2014; Braga et al, 2018; Fiorini et al, 2018; Kampf et al, 2013), such as the guidelines from the Centers for Disease Control and Prevention (CDC; O’Grady et al, 2011), the Royal College of Nursing (RCN, 2016), and the Infusion Nurses Society (INS, 2016) This scenario is disturbing, since SoC establish the expected levels of performance for clinicians and provide criteria for accountability, supported by graded research evidence and updated by clinical experts regularly, striving for a more efficient, safer, and more patient-centered care (Ray-Barruel & Rickard, 2018). Conclusion: Overall, a substantial number of PIVC-related practices does not comply with current SoC recommendations, which may pose a risk to patient safety and care quality
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