Determinants of the optimal selection of vascular access devices: A systematic review underpinned by the COM-B behavioural model.
Ismael Fernández-Fernández, Enrique Castro-Sánchez, Ian Blanco-Mavillard
PMID 38698552WHAT IT FOUND
Vascular access studies mostly described training, equipment, algorithms, and difficulty scales.
Only one addressed motivation, so why clinicians choose an appropriate catheter remains poorly explained.
Key findings
01The review included 16 articles; physical opportunity was reported in 15 studies, with 12 describing resources, 3 algorithms, and 5 difficulty scales.
02Social opportunity was identified in 12 studies, mostly specialist vascular access teams supporting insertion and maintenance.
03Only one study addressed motivation, explaining to physicians and nurses why standardized practices were needed to reduce unnecessary central catheter use and infection risk.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review did not exclude studies based on quality scores, and the included studies varied widely in design and methodological quality. There is no agreed definition of optimal vascular access device selection, so the authors used their own definition and a broad search. Most studies were from hospitals, adult patients, and high-resource countries, so they say little about home care, long-stay units, paediatrics, or patient and family perspectives. The review found no qualitative papers, so motivation, interpersonal influence and cultural factors were not explored. The review reports what actions studies described, not whether those actions changed patient outcomes.
Declared interests
The research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors, and the authors declare no competing interests.
The easy way to misread this
Do not read this as evidence that vascular access teams, ultrasound training, or difficulty scales reduce complications. The review mapped what actions studies reported, not whether those actions improved patient outcomes.