Cargando…

Peripheral intravenous catheter insertion and use of ultrasound in patients with difficult intravenous access: Australian patient and practitioner perspectives to inform future implementation strategies

OBJECTIVE: To understand healthcare worker and patient experience with peripheral intravenous catheter (PIVC) insertion in patients with difficult intravenous access (DIVA) including the use of ultrasound (US). METHODS: Descriptive study using 1-on-1 semi-structured interviews conducted between Augu...

Descripción completa

Detalles Bibliográficos
Autores principales: Schults, Jessica A., Calleja, Pauline, Slaughter, Eugene, Paterson, Rebecca, Rickard, Claire M., Booker, Catriona, Marsh, Nicole, Fenn, Mary, Kelly, Jenny, Snelling, Peter J., Byrnes, Joshua, Keijzers, Gerben, Cooke, Marie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9231778/
https://www.ncbi.nlm.nih.gov/pubmed/35749443
http://dx.doi.org/10.1371/journal.pone.0269788
_version_ 1784735421566025728
author Schults, Jessica A.
Calleja, Pauline
Slaughter, Eugene
Paterson, Rebecca
Rickard, Claire M.
Booker, Catriona
Marsh, Nicole
Fenn, Mary
Kelly, Jenny
Snelling, Peter J.
Byrnes, Joshua
Keijzers, Gerben
Cooke, Marie
author_facet Schults, Jessica A.
Calleja, Pauline
Slaughter, Eugene
Paterson, Rebecca
Rickard, Claire M.
Booker, Catriona
Marsh, Nicole
Fenn, Mary
Kelly, Jenny
Snelling, Peter J.
Byrnes, Joshua
Keijzers, Gerben
Cooke, Marie
author_sort Schults, Jessica A.
collection PubMed
description OBJECTIVE: To understand healthcare worker and patient experience with peripheral intravenous catheter (PIVC) insertion in patients with difficult intravenous access (DIVA) including the use of ultrasound (US). METHODS: Descriptive study using 1-on-1 semi-structured interviews conducted between August 2020 and January 2021. Purposeful sampling was used to recruit healthcare practitioners (HCPs) and patients with DIVA who had PIVC experience. Data were analysed using inductive thematic analysis. Interview data were than mapped to the implementation theory Behaviour Change Wheel to inform implementation strategies. RESULTS: In total 78 interviews (13 patients; 65 HCPs) were completed with respondents from metropolitan (60%), regional (25%) and rural/remote (15%) settings across Australia. Thematic analysis revealed 4 major themes: i) Harmful patient experiences persist, with patient insights not leveraged to effect change; ii) ‘Escalation’ is just a word on the front lines; iii) Heightened risk of insertion failure without resources and training; and iv) Paving the way forward–‘measures need to be in place to prevent failed insertion attempts. Themes were mapped to the behaviour change wheel and implementation strategies developed, these included: staff education, e-health record for DIVA identification, DIVA standard of care and DIVA guidelines to support escalation and ultrasound use. CONCLUSION(S): DIVA patients continue to have poor healthcare experiences with PIVC insertion. There is poor standardisation of DIVA assessment, escalation, US use and clinician education across hospitals. Quality, safety, and education improvement opportunities exist to improve the patient with DIVA experience and prevent traumatic insertions. We identified a number of implementation strategies to support future ultrasound and DIVA pathway implementation.
format Online
Article
Text
id pubmed-9231778
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-92317782022-06-25 Peripheral intravenous catheter insertion and use of ultrasound in patients with difficult intravenous access: Australian patient and practitioner perspectives to inform future implementation strategies Schults, Jessica A. Calleja, Pauline Slaughter, Eugene Paterson, Rebecca Rickard, Claire M. Booker, Catriona Marsh, Nicole Fenn, Mary Kelly, Jenny Snelling, Peter J. Byrnes, Joshua Keijzers, Gerben Cooke, Marie PLoS One Research Article OBJECTIVE: To understand healthcare worker and patient experience with peripheral intravenous catheter (PIVC) insertion in patients with difficult intravenous access (DIVA) including the use of ultrasound (US). METHODS: Descriptive study using 1-on-1 semi-structured interviews conducted between August 2020 and January 2021. Purposeful sampling was used to recruit healthcare practitioners (HCPs) and patients with DIVA who had PIVC experience. Data were analysed using inductive thematic analysis. Interview data were than mapped to the implementation theory Behaviour Change Wheel to inform implementation strategies. RESULTS: In total 78 interviews (13 patients; 65 HCPs) were completed with respondents from metropolitan (60%), regional (25%) and rural/remote (15%) settings across Australia. Thematic analysis revealed 4 major themes: i) Harmful patient experiences persist, with patient insights not leveraged to effect change; ii) ‘Escalation’ is just a word on the front lines; iii) Heightened risk of insertion failure without resources and training; and iv) Paving the way forward–‘measures need to be in place to prevent failed insertion attempts. Themes were mapped to the behaviour change wheel and implementation strategies developed, these included: staff education, e-health record for DIVA identification, DIVA standard of care and DIVA guidelines to support escalation and ultrasound use. CONCLUSION(S): DIVA patients continue to have poor healthcare experiences with PIVC insertion. There is poor standardisation of DIVA assessment, escalation, US use and clinician education across hospitals. Quality, safety, and education improvement opportunities exist to improve the patient with DIVA experience and prevent traumatic insertions. We identified a number of implementation strategies to support future ultrasound and DIVA pathway implementation. Public Library of Science 2022-06-24 /pmc/articles/PMC9231778/ /pubmed/35749443 http://dx.doi.org/10.1371/journal.pone.0269788 Text en © 2022 Schults et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Schults, Jessica A.
Calleja, Pauline
Slaughter, Eugene
Paterson, Rebecca
Rickard, Claire M.
Booker, Catriona
Marsh, Nicole
Fenn, Mary
Kelly, Jenny
Snelling, Peter J.
Byrnes, Joshua
Keijzers, Gerben
Cooke, Marie
Peripheral intravenous catheter insertion and use of ultrasound in patients with difficult intravenous access: Australian patient and practitioner perspectives to inform future implementation strategies
title Peripheral intravenous catheter insertion and use of ultrasound in patients with difficult intravenous access: Australian patient and practitioner perspectives to inform future implementation strategies
title_full Peripheral intravenous catheter insertion and use of ultrasound in patients with difficult intravenous access: Australian patient and practitioner perspectives to inform future implementation strategies
title_fullStr Peripheral intravenous catheter insertion and use of ultrasound in patients with difficult intravenous access: Australian patient and practitioner perspectives to inform future implementation strategies
title_full_unstemmed Peripheral intravenous catheter insertion and use of ultrasound in patients with difficult intravenous access: Australian patient and practitioner perspectives to inform future implementation strategies
title_short Peripheral intravenous catheter insertion and use of ultrasound in patients with difficult intravenous access: Australian patient and practitioner perspectives to inform future implementation strategies
title_sort peripheral intravenous catheter insertion and use of ultrasound in patients with difficult intravenous access: australian patient and practitioner perspectives to inform future implementation strategies
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9231778/
https://www.ncbi.nlm.nih.gov/pubmed/35749443
http://dx.doi.org/10.1371/journal.pone.0269788
work_keys_str_mv AT schultsjessicaa peripheralintravenouscatheterinsertionanduseofultrasoundinpatientswithdifficultintravenousaccessaustralianpatientandpractitionerperspectivestoinformfutureimplementationstrategies
AT callejapauline peripheralintravenouscatheterinsertionanduseofultrasoundinpatientswithdifficultintravenousaccessaustralianpatientandpractitionerperspectivestoinformfutureimplementationstrategies
AT slaughtereugene peripheralintravenouscatheterinsertionanduseofultrasoundinpatientswithdifficultintravenousaccessaustralianpatientandpractitionerperspectivestoinformfutureimplementationstrategies
AT patersonrebecca peripheralintravenouscatheterinsertionanduseofultrasoundinpatientswithdifficultintravenousaccessaustralianpatientandpractitionerperspectivestoinformfutureimplementationstrategies
AT rickardclairem peripheralintravenouscatheterinsertionanduseofultrasoundinpatientswithdifficultintravenousaccessaustralianpatientandpractitionerperspectivestoinformfutureimplementationstrategies
AT bookercatriona peripheralintravenouscatheterinsertionanduseofultrasoundinpatientswithdifficultintravenousaccessaustralianpatientandpractitionerperspectivestoinformfutureimplementationstrategies
AT marshnicole peripheralintravenouscatheterinsertionanduseofultrasoundinpatientswithdifficultintravenousaccessaustralianpatientandpractitionerperspectivestoinformfutureimplementationstrategies
AT fennmary peripheralintravenouscatheterinsertionanduseofultrasoundinpatientswithdifficultintravenousaccessaustralianpatientandpractitionerperspectivestoinformfutureimplementationstrategies
AT kellyjenny peripheralintravenouscatheterinsertionanduseofultrasoundinpatientswithdifficultintravenousaccessaustralianpatientandpractitionerperspectivestoinformfutureimplementationstrategies
AT snellingpeterj peripheralintravenouscatheterinsertionanduseofultrasoundinpatientswithdifficultintravenousaccessaustralianpatientandpractitionerperspectivestoinformfutureimplementationstrategies
AT byrnesjoshua peripheralintravenouscatheterinsertionanduseofultrasoundinpatientswithdifficultintravenousaccessaustralianpatientandpractitionerperspectivestoinformfutureimplementationstrategies
AT keijzersgerben peripheralintravenouscatheterinsertionanduseofultrasoundinpatientswithdifficultintravenousaccessaustralianpatientandpractitionerperspectivestoinformfutureimplementationstrategies
AT cookemarie peripheralintravenouscatheterinsertionanduseofultrasoundinpatientswithdifficultintravenousaccessaustralianpatientandpractitionerperspectivestoinformfutureimplementationstrategies