Qualitative Analysis of Central and Midline Care in the Medical/Surgical Setting

Author Affiliation: Clinical Nurse Specialist, NCH Healthcare System, Naples, Florida.
Clinical nurse specialist CNS (Impact Factor: 0.99). 11/2012; 26(6):323-8. DOI: 10.1097/NUR.0b013e31826e3f2a
Source: PubMed


: Community hospital medical-surgical nurses have a limited understanding of the complexities of preventing central line-associated bloodstream infections (CLABSIs). The purpose of this study was to look at the phenomenon of central line care from a human perspective and to develop an understanding of the lived experience as it relates to nursing care.
: A qualitative, phenomenology framework was applied for this study.
: The study was performed at a seasonally fluctuating, 400- to 600-bed community hospital in southwest Florida.
: Fifteen full-time medical-surgical bedside registered nurses, 8 working the 12-hour day shift and 7 working the 12-hour night shift, were interviewed.
: Experiences from recorded, 45-minute, in-depth telephone interviews from nurses assigned to 4 medical-surgical units, with the greatest CLABSI frequency, were analyzed.
: Findings identified myriad challenges when it comes to administering proper technique and preventing CLABSIs. The themes, time and locus of responsibility, patient population and unit, and variations in experience with CLABSIs, are illuminated.
: Nurses have strong feelings and suggestions for organizations to consider in reducing infection rates. Line care education should focus on the relationship of the nurse to understanding CLABSIs, education on line care, supplies, and charting/documentation.
: The revealed nature and meaning of the human experience of the central line dressing change and skill actions, identified by the nurses, were brought to the CLABSI committee, and a plan was formed. Six months after implementation of the plan, based on the nurses' lived experiences, the rate of infections has dropped 64%.

139 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: Treatments involving chemotherapy require central venous access, such as a Peripherally Inserted Central (PICC) line. The aim of the study was to describe patients’ experiences of living with a PICC line during chemotherapy treatment. The study comprised interviews with 10 patients and was analyzed using manifest qualitative content analysis. The categories The importance of security, The importance of contentedness, and Feeling confident in using the PICC line were identified. To contribute to patient safety and empowerment in health care, nurses must be well trained in PICC line care. Therefore, evidence-based knowledge about central venous access is necessary for patients’ security and contentedness and to improve quality of care and increase patients’ well-being in central venous access care activities in the future.
    Home Health Care Management &amp Practice 08/2015; 27(3). DOI:10.1177/1084822314566300