Russell Emily, Chan Raymond Javan, Marsh Nicole, New Karen
Cancer Care Services, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Q4029 Queensland, Australia.
Cancer Care Services, Royal Brisbane and Women's Hospital, Butterfield Street, Herston, Q4029 Queensland, Australia; Centre for Health Practice Innovation, Griffith University, Nathan, Queensland, Australia.
Eur J Oncol Nurs. 2014 Jun;18(3):231-5. doi: 10.1016/j.ejon.2013.11.010. Epub 2013 Dec 27.
The use of intravascular devices is associated with a number of potential complications. Despite a number of evidence-based clinical guidelines in this area, there continues to be nursing practice discrepancies. This study aims to examine nursing practice in a cancer care setting to identify nursing practice and areas for improvement respective to best available evidence.
A point prevalence survey was undertaken in a tertiary cancer care centre in Queensland, Australia. On a randomly selected day, four nurses assessed intravascular device related nursing practices and collected data using a standardized survey tool.
58 inpatients (100%) were assessed. Forty-eight (83%) had a device in situ, comprising 14 Peripheral Intravenous Catheters (29.2%), 14 Peripherally Inserted Central Catheters (29.2%), 14 Hickman catheters (29.2%) and six Port-a-Caths (12.4%). Suboptimal outcomes such as incidences of local site complications, incorrect/inadequate documentation, lack of flushing orders, and unclean/non intact dressings were observed.
This study has highlighted a number of intravascular device related nursing practice discrepancies compared with current hospital policy. Education and other implementation strategies can be applied to improve nursing practice. Following education strategies, it will be valuable to repeat this survey on a regular basis to provide feedback to nursing staff and implement strategies to improve practice. More research is required to provide evidence to clinical practice with regards to intravascular device related consumables, flushing technique and protocols.
血管内装置的使用会引发一系列潜在并发症。尽管该领域有许多循证临床指南，但护理实践仍存在差异。本研究旨在调查癌症护理环境中的护理实践，以确定与现有最佳证据相关的护理实践及改进领域。
在澳大利亚昆士兰州的一家三级癌症护理中心进行了一项现况调查。在随机选定的一天，四名护士评估了与血管内装置相关的护理实践，并使用标准化调查工具收集数据。
对58名住院患者（100%）进行了评估。48名（83%）患者体内有装置，包括14根外周静脉导管（29.2%）、14根经外周静脉穿刺中心静脉导管（29.2%）、14根希克曼导管（29.2%）和6根植入式静脉输液港（12.4%）。观察到一些不理想的结果，如局部并发症发生率、记录不正确/不充分、缺乏冲洗医嘱以及敷料不清洁/不完整。
与当前医院政策相比，本研究突出了一些与血管内装置相关的护理实践差异。可应用教育和其他实施策略来改善护理实践。实施教育策略后，定期重复此项调查以向护理人员提供反馈并实施改进实践的策略将很有价值。需要更多研究为血管内装置相关耗材、冲洗技术和方案的临床实践提供证据。
