Santos-Costa Paulo, Paiva-Santos Filipe, Sousa Liliana B, Bernardes Rafael A, Ventura Filipa, Fearnley William David, Salgueiro-Oliveira Anabela, Parreira Pedro, Vieira Margarida, Graveto João
The Health Sciences Research Unit: Nursing, Nursing School of Coimbra, 3004-011 Coimbra, Portugal.
Instituto Ciências da Saúde, Universidade Católica Portuguesa, 4169-005 Porto, Portugal.
J Pers Med. 2022 Jan 24;12(2):151. doi: 10.3390/jpm12020151.
A significant number of adult oncology patients require at least one peripheral intravenous catheter to fulfill their therapeutic plan. Recent evidence indicates that catheter failure rates are high in this cohort, impacting care outcomes and patient experience during cancer treatment. This reality represents a challenge to nurses worldwide since in most international settings they are responsible for delivering quality care during the insertion and maintenance of such devices. This study aims to explore current nursing practices regarding the insertion, maintenance, and surveillance of peripheral intravenous catheters in oncology patients. A two-phase mix-method study was conducted with the nursing team from the surgical ward of a large oncology hospital in Portugal. In phase one (observational prospective study), nurses' practices during catheter insertion and maintenance were observed by the research team and recorded using standardized instruments and validated scales. In phase two, three online focus groups were conducted with the nursing team to present the results observed in phase one and explore their perceptions of current practices. All ethical principles were assured throughout the study. Significant divergent practices were observed and identified by the nurses, especially concerning patient involvement, nurses' adherence to the aseptic, non-touch technique, catheter stabilization and dressing, and catheter flushing and locking. Such practices may partially explain the high complication rate found (26%) and substantiate the need for future intervention in this field.
相当数量的成年肿瘤患者需要至少一根外周静脉导管来完成他们的治疗计划。最近的证据表明，在这一群体中导管故障率很高，影响了癌症治疗期间的护理结果和患者体验。这一现实对全球护士构成了挑战，因为在大多数国际环境中，她们负责在这类设备的插入和维护过程中提供高质量护理。本研究旨在探讨肿瘤患者外周静脉导管插入、维护和监测方面的当前护理实践。对葡萄牙一家大型肿瘤医院外科病房的护理团队进行了一项两阶段混合方法研究。在第一阶段（观察性前瞻性研究），研究团队观察护士在导管插入和维护过程中的操作，并使用标准化工具和经过验证的量表进行记录。在第二阶段，与护理团队进行了三个在线焦点小组讨论，以展示在第一阶段观察到的结果，并探讨他们对当前实践的看法。在整个研究过程中，所有伦理原则都得到了保障。护士们观察并发现了显著不同的操作，特别是在患者参与、护士对无菌非接触技术的遵守、导管固定和敷料、以及导管冲洗和封管方面。这些操作可能部分解释了所发现的高并发症发生率（26%），并证实了该领域未来进行干预的必要性。
