Not "just" an intravenous line: Consumer perspectives on peripheral intravenous cannulation (PIVC). An international cross-sectional survey of 25 countries.
Not "just" an intravenous line: Consumer perspectives on peripheral intravenous cannulation (PIVC). An international cross-sectional survey of 25 countries.
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DOI：
10.1371/journal.pone.0193436
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Rickard CM
中科院分区：
文献类型：
--
作者：
Cooke M;Ullman AJ;Ray-Barruel G;Wallis M;Corley A;Rickard CM
外周血管内插管/导管（PIVC）插入是一种常见的侵入性手术，但治疗结束前PIVC失败率高得不可接受。由于PIVC失败会中断治疗，重新插入可能会给患者带来痛苦，因此预防PIVC失败是一项重要的患者结局。消费者参与PIVC护理以防止失败是一种尚未开发的资源。本研究旨在了解消费者的PIVC经验，建立PIVC插入和护理相关的方面，并比较成人消费者的经验，成人照顾者的孩子。通过社交媒体发布了一项国际性、基于网络的横断面调查，邀请在过去五年中经历过PIVC的18岁以下儿童的成年消费者和成年护理者（成年人和成年护理者各进行一次调查）完成一项10项调查。因此，抽样偏倚是一种限制，应根据这一点仔细考虑结果。共有来自25个国家的712名受访者，主要是女性（87.1%）和成年人（80%）。略高于50%的成人将插入描述为中度疼痛或更严重，插入困难程度（0-10量表）确定为中度（中位数4，IQR 1，7）。成人护理者报告在插入过程中疼痛和插入困难明显更多（均p < 0.001）。与成人相比，儿童的首次插入尝试失败率更高（89/139 [64%] vs 221/554 [40%]; p < 0.001），23%的儿童需要≥ 4次尝试，而成人为9%（p < 0.0001）。开放式问题中出现了三个主题：安全和一致的PIVC护理的意义;员工培训和能力的重要性;以及沟通的价值。对于消费者来说，PIVC体验可能会很痛苦、有压力和令人沮丧。临床医生和政策制定者的优先事项应包括使用疼痛缓解作为标准实践，以减少与PIVC插入相关的疼痛，并制定策略以增加首次PIVC插入尝试的成功率，特别是对于儿童和老年消费者。
Peripheral intravascular cannula/catheter (PIVC) insertion is a common invasive procedure, but PIVC failure before the end of therapy is unacceptably high. As PIVC failure disrupts treatment and reinsertion can be distressing for the patient, prevention of PIVC failure is an important patient outcome. Consumer participation in PIVC care to prevent failure is an untapped resource. This study aimed to understand consumers’ PIVC experience; establish aspects of PIVC insertion and care relevant to them; and to compare experiences of adult consumers to adult carers of a child. An international, web-based, cross-sectional survey was distributed via social media inviting adult consumers and adult carers of a child under 18 years who had experienced having a PIVC in the last five years (one survey each for adults and adult carers) to complete a 10-item survey. As such, sampling bias is a limitation and results should be carefully considered in light of this. There were 712 respondents from 25 countries, mainly female (87.1%) and adults (80%). A little over 50% of adults described insertion as moderately painful or worse, with level of insertion difficulty (0–10 scale) identified as moderate (median 4, IQR 1, 7). Adult carers reported significantly more pain during insertion and insertion difficulty (both p < 0.001). Rates of first insertion attempt failure were higher in children compared with adults (89/139 [64%] vs 221/554 [40%]; p < 0.001), and 23% of children required ≥ 4 attempts, compared with 9% of adults (p < 0.0001). Three themes from open-ended question emerged: Significance of safe and consistent PIVC care; Importance of staff training and competence; and Value of communication. The PIVC experience can be painful, stressful and frustrating for consumers. Priorities for clinicians and policy makers should include use of pain relief as standard practice to reduce the pain associated with PIVC insertion and developing strategies to increase first PIVC insertion attempt success particularly for children and older consumers.
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影响因子：
1.9
作者：
Carr, Peter J.;Rippey, James C. R.;Rickard, Claire M.
通讯作者：
Rickard, Claire M.
影响因子：
1.7
作者：
Cuper, Natascha J.;de Graaff, Jurgen C.;Kalkman, Cor J.
通讯作者：
Kalkman, Cor J.
影响因子：
2.2
作者：
Bond, Mary;Crathorne, Louise;Powell, Roy
通讯作者：
Powell, Roy
影响因子：
1.3
作者：
Blignault, Ilse;Aspinall, Diana;Hyman, Kay
通讯作者：
Hyman, Kay
影响因子：
3.2
作者：
Couet, Nicolas;Desroches, Sophie;Legare, France
通讯作者：
Legare, France