Nurse and patient satisfaction with three types of venous access devices.

PURPOSE/OBJECTIVES: To examine patient and nurse satisfaction with three types of venous access devices (VADs)--port, Groshong (Bard Access Systems, Salt Lake City, UT), and Hicman (Bard Access Systems)--and to identify the problems and benefits experienced with each type of device.

DESIGN

A descriptive, correlational quality-assurance study.

SETTING

An outpatient oncology/hematology clinic in a midwestern United States academic hospital with a comprehensive cancer center.

SAMPLE

A convenience sample of 85 patients who had a port, Groshong catheter, or Hickman catheter and the clinic nurses who provided their care.

METHOD

Consecutive patients meeting study criteria were invited to complete self-report questionnaires at the time of their clinic visits. Clinic nurses who cared for these patients also completed questionnaires.

FINDINGS

Patients' reports of benefits did not differ by device, but they reported fewer blood-drawing problems with ports than with Groshong on Hickman catheters. Patients and nurses reported infections and clots more often with Groshong catheters than with the other two devices, Patients indicated that healthcare workers seemed most knowledgeable about Hickman catheters. Patients with ports reported more problems with access to the device, development of hematomas, and anxiety. Nurses reported more flow rate problems with Groshong catheters than with Hickman catheters. Patients and nurses reported no flow rate problems with ports.

CONCLUSIONS

Each device was associated with a specific problem, yet in the global satisfaction ratings, patients expressed the greatest satisfaction with Hickman catheters and ports. Nurses tended to be least satisfied with Groshong catheters.

IMPLICATIONS FOR NURSING PRACTICE

Nurses need to ensure that other care providers have appropriate information on the care of VADs. This could be accomplished via written instructions on VAD care and followup telephone calls to care providers. A need exists for continued patient education on VAD care to minimize complications. The selection of an appropriate VAD should be based on the patient's best interests rather than on nurses' preferences.