St. Joseph Hospital and Medical Center, Dignity Health, Phoenix, Arizona.
Ann Plohal, PhD, RN, APRN, ACNS-BC, CRNI®, VA-BC , has 38 years of experience as a registered nurse, with 20 years of experience in infusion therapy. She is currently employed at St. Joseph Hospital and Medical Center for the past 4 years with the registered nurses' vascular access team (VAT). Her role includes the development of the VAT with hands-on application, as well as facility and system involvement with central line-associated bloodstream infection prevention and infusion practices. She is a past president of Infusion Nurses Society (2014-2015) and has published multiple articles on infusion therapy in peer-reviewed journals.
J Infus Nurs. 2021;44(1):26-33. doi: 10.1097/NAN.0000000000000408.
Hospitalized patients require venous access for procedures, treatments, or therapies. The short peripheral catheter (SPC) is one option for patients who need intravenous (IV) access for treatment. Patients with difficult vasculature sometimes require multiple attempts to obtain SPC access. The aim of this study was to gain an understanding of adult patients' experiences with SPC insertion, specifically those with difficult venous access. Ten participants were purposely sampled over a 2-month period for semistructured interviews from the medical, surgical, and telemetry units at an inner city, 750-bed trauma hospital in the southwestern United States. Four key themes developed from the interview data: skills and techniques of the clinicians, distress and the SPC insertion experience, physical and emotional pain, and patient/clinician communication. These themes provided ways that clinicians might improve the patient experience, including: ensuring experienced and confident inserters are available to insert SPCs, utilizing distraction and pain methods to decrease pain perception, communicating with patients regarding site selection and expectations during SPC insertion, and identifying patients with difficult vascular access to limit attempts per patient to preserve vascular sites.
住院患者需要静脉通路进行手术、治疗或疗法。对于需要静脉（IV）治疗的患者，短外周导管（SPC）是一种选择。有时，血管条件困难的患者需要多次尝试才能获得 SPC 通路。本研究旨在了解成年患者使用 SPC 插入的体验，特别是那些静脉通路困难的患者。在 2 个月的时间里，从美国西南部一家拥有 750 张床位的城市创伤医院的医疗、外科和遥测病房中，有目的的抽取了 10 名参与者进行半结构式访谈。从访谈数据中得出了 4 个主要主题：临床医生的技能和技术、SPC 插入体验的困扰、身体和情绪上的痛苦以及患者/临床医生的沟通。这些主题提供了一些方法，临床医生可以通过这些方法来改善患者的体验，包括：确保有经验和自信的插入器可用于插入 SPC；利用分散注意力和止痛方法来降低疼痛感知；在 SPC 插入过程中与患者就部位选择和期望进行沟通；以及识别血管通路困难的患者，以限制每位患者的尝试次数，从而保护血管部位。
