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Registered Nurses´Adherence to Clinical Guidelines Regarding Peripheral Venous Catheters: A Structured Observational Study
Responsible organisation
2008 (English)In: Worldviews on Evidence-Based Nursing, ISSN 1545-102X , Vol. 5, no 3, 148-159 p.Article in journal (Refereed) PublishedAlternative title
Sjuksköterskors följsamhet till kliniska riktlinjer avseende PVK : en strukturerad observationsstudie (Swedish)
Abstract [en]

peripheral catheterization is a common procedure, which affects numerous patients in health care today. having peripheral venous catheters in situ might lead to complications such as thrombophlebitis and sepsis, and clinical guidelines have been developed to assist nurses in their decisionmaking. Several reasons are given for clinicians not always adhering to clinical guidelines, although such adherence might lead to fewer complications. This papaer aims to describe registered nurses´adherence to national and local guidelines on peripheral venous catheters by focusing on time in situ, site, size, and documentation at the dressing. An additional aim is to describe the thrombophlebitis frequency associated with peripheral venous catheters in situ. Structured observational study of patients with peripheral venous catheters in situ, conducted from December 2004 to June 2005. data of 343 peripheral venous catheters were analyzed. Nurses partly adhered to national and local guidelines concerning size and site. Guideline adherence concerning documentation at the dressing was low. The results showed that non-adherence pertaining to time in situ varied between 5% and 26.3%. Differences between adherence to national or local guidelines were shown for size, site, and documentation at the dressing. Mild thrombophlebitis (Grades 1 and 2) was observed in 7.0%. Nurses partly adhered to clinical guidelines. Differences in guideline adherence were observed for wards with local or national guigelines, as well as for wards with different specialities. In accordance with clinical guidelines, the nurses seemed to replace or remove peripheral venous catheters before any severe complications arose. Adherence to clinical guidelines has an impact for preventing patient complications and thus it is essential that nurses are aware of their existence. Feedback and discussions of guideline adherence or of complication rates might influence nurses´clinical decision-making.

Abstract [sv]

Perifer venkateter är vanligt bland en stor del patienter idag. Användandet av perifer venkateter (PVK) kan leda till komplikationer som t ex tromboflebit och sepsis och kliniska riktlinjer har utarbetats för att stödja sjuksköterskor som handhar PVK. Det finns flera orsaker till varför kliniskt verksamma inte följer kliniska riktlinjer även om detta skulle minska komplikationsfrekvensen. Den här artikeln beskriver sjuksköterskors följsamhet till nationella och lokala kliniska riktlinjer vad gäller PVK och fokuserar på tid in situ, placering och dokumentaion vid förbandet. Ett ytterligare asyfte är att beskriva förekomsten av tromboflebiter i anslutning till PVK in situ, Metoden är strukturerade observationer av patienter med PVK. Data som analyserades gäller 343 PVK och är insamlat mellan december 2004 till juni 2005. Resultatet visar att sjuksköterskorna delvis följer riktlinjerna vad gäller storlek och placering. det var låg följsamhet vad gäller dokumentationen. icke följsamheten vad gäller tid in situ varierade mellan 5-26,3%, skillnader visade för storlek, placering och dokumentation. Mild tromboflebit (grad 1 och 2) observerades i 7% av fallen. Slutsatserna är att sjuksköterskors följsamhet till kliniska riktlinjer varierar men att sjuksköterskorna verkar byta leer ta bort PVK innan det uppstår alvarliga komplikationer. Återkoppling och diskussioner om följsamhet eller om komplikationer kan ha ett inflytande på sjuksköterskors kliniska beslutsfattande . Nyckelord: kliniskt beslutsfattande, följsamhet till riktlinjer, perifer venkateter, strukturerade observationer

Place, publisher, year, edition, pages
Blackwell , 2008. Vol. 5, no 3, 148-159 p.
Keyword [en]
decision making, guideline adherence, peripheral cetheterization, practice guidelines, structured observations
National Category
Nursing
Identifiers
URN: urn:nbn:se:bth-7247DOI: 10.1111/j.1741-6787.2008.00105.xISI: 000259228900005Local ID: oai:bth.se:forskinfo65CF6B5B2AC27C68C12574FE006B4F46OAI: oai:DiVA.org:bth-7247DiVA: diva2:834837
Available from: 2012-09-21 Created: 2008-11-11 Last updated: 2015-06-30Bibliographically approved

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