Peripheral intravenous catheter insertion difficulty and registered nurse performance

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To describe the characteristics, problems, and interventions associated with performing peripheral intravenous catheterisation (PIVC) in difficult situations when registered nurses (RNs) need support from critical care nurses (CCNs)” Engström and Forsberg (2018).

Abstract:

OBJECTIVES: To describe the characteristics, problems, and interventions associated with performing peripheral intravenous catheterisation (PIVC) in difficult situations when registered nurses (RNs) need support from critical care nurses (CCNs).

BACKGROUND: Only a few studies have focused on PIVC problems or interventions to promote success. There is limited research on the education, knowledge, confidence, and skills of RNs associated with successful PIVCs. Design A descriptive cross-sectional survey design was used.

RESULTS: A total of 101 questionnaires were completed by CCNs (n=32) and 92 by RNs (n=83); the total number of participants was 115. The same CCNs and RNs could participate several times on different occasions. Statistical analyses were performed using descriptive statistics. The patterns differed in part between the RNs who needed support and the CCNs who provided the support. Both RNs and CCNs used ultrasound to a very low extent (2.2% vs. 1.0%). The RNs indicated to a significantly higher extent (p=0.02) that the veins were invisible and that they had performed the optional interventions. The success rate for CCNs was considerably high (86.1%). The most common place for successful insertion was the wrist. CCNs performed fewer interventions, and they informed the patients and assessed that the veins were fragile to a higher extent.

CONCLUSIONS: Superior nursing skills are required in order to adapt and assess specific situations related to PIVC difficulties and to choose the adequate interventions. Young and newly graduated RNs should be offered individualised training during the post-educational period on how to assess problems and perform PIVCs in specific difficult situations.

RELEVANCE TO CLINICAL PRACTICE: Simulation is suggested for practical training in order to increase patient safety related to the performance of technical skills such as PIVC.

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Reference:

Engström, Å. and Forsberg, A. (2018) Peripheral intravenous catheter difficulty – A clinical survey of registered nurse and critical care nurse performance. Journal of Clinical Nursing. September 4th. .

doi: 10.1111/jocn.14668.

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