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“To investigate the patient experience of PICC insertion, the significance of arm choice and the impact of the device on activities of daily living.” Sharp et al (2014).

Reference:

Sharp, R., Grech, C., Fielder, A., Mikocka-Walus, A., Cummings, M. and Esterman, A. (2014) The patient experience of a Peripherally Inserted Central Catheter (PICC): a qualitative descriptive study. Contemporary Nurse. July 19th. [epub ahead of print].

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Abstract:

Aim: To investigate the patient experience of PICC insertion, the significance of arm choice and the impact of the device on activities of daily living.

Background: Arm choice for PICC insertion is often determined by PICC nurses with little input from consumers. There are few studies that have investigated the patient experience of living with a PICC and none that have examined the impact of arm choice from the consumer’s perspective.

Method: Participants were recruited in a hospital whilst they waited for PICC insertion. A purposeful sampling approach was used to select participants based on diagnosis types. Semistructured telephone interviews were conducted November 2012-August 2013. Transcripts of the interviews were analysed using thematic analysis.

Findings: Ten participants were interviewed. Four themes were identified: (i) apprehension/ adaptation/ acceptance, (ii) impact of treatment, (iii) asking questions (trusting doctors) and (iv) freedom. Although initially apprehensive, participants adapted to the PICC and came to accept that the device allowed convenient access for treatment. This allowed them the freedom to receive treatment at home. The use of the dominant or non-dominant arm for PICC insertion had marginal impact on activities of daily living for participants. Auxiliary factors such as the infusion pump had a significant impact for those who received outpatient treatment. For those participants who did not understand the procedure, many did not seek clarification and trusted medical and nursing staff to make decisions for them.

Conclusion: Nurses should involve consumers in clinical decision-making and provide individualised information and support that facilitates adaptation for patients living with a PICC.

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