RNSurveyNursing open2020

Patient experiences with peripherally inserted venous catheters- A cross-sectional, multicentre study in Norway.

Ann-Chatrin Linqvist Leonardsen, Ellen Marie Lunde, Stine Thorvaldsen Smith and 1 others

PMID 32257263

WHAT IT FOUND

Patients with PICCs or Midlines reported discomfort, anxiety and daily-life restrictions, and complications were the only factor linked to how patients rated their experience.

Most still preferred the catheter to a peripheral line and would choose it again.

Key findings

01359 of 1,049 invited patients (34%) responded 2 weeks after insertion; responders' mean age was 62.4 years and non-responders' mean age was 68.3 years, a significant difference.

02Complications were the only variable with a unique statistically significant association with patient experiences; gender, age, height, weight, length of stay, comorbidity, diagnosis, treatment strategy, catheter type and arm were not significant.

03Free-text comments identified five themes, including information and healthcare personnel competence, and included reports of ward nurses seeming unsure and patients reminding them to flush.

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

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What it does not show

Only 34% of invited patients responded, and non-responders were significantly older, so experiences of older or less engaged patients may be missing. Not all eligible patients were invited; nurse anaesthetists omitted patients who were somnolent, terminally ill or very vulnerable, which may select for more stable patients. The study used a structured questionnaire, not interviews, so it may miss more detailed reasons behind experiences. Free-text comments were short and not analysed thoroughly, so themes are illustrative rather than a full qualitative finding. Complications were taken from medical records without objective incidence measures, so the strength of the complication-experience link cannot be fully checked. Hospitals differed in how many patients were still hospitalized, comorbidity, diagnosis and treatment, so hospital differences may reflect patient mix rather than care alone. PICCs and Midlines were analysed together, although the paper says patients are not familiar with the differences and the regression found no significant association by catheter type. Sample size was not calculated because the questionnaire had no total score; the study aimed for about 300 patients.

The easy way to misread this

Do not read most would choose the catheter again as evidence the catheter is comfortable or complication-free. Only 34% of invited patients responded, non-responders were significantly older, every item indicated quality improvement potential, and complications were independently associated with experience ratings.

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