Journal article
Peripheral intravenous catheter management in childbirth (PICMIC): A multi-centre, prospective cohort study
Journal of Advanced Nursing, Vol.77(11), pp.4451-4458
2021
Abstract
Background:
Childbirth is a normal, physiological process, yet intervention is common. Arguably the most common intervention is the insertion of a peripheral intravenous catheter; however, there are few studies guiding best practice. This study aimed to describe current intravenous catheter insertion practice, explore clinician decision-making during insertion and perceptions of women.
Methods:
This prospective, observational cohort study recruited 101 women and clinicians from two Australian regional hospitals. Data collection incorporated non-participant observation, brief interview and chart review. Variables measured included pain score, insertion attempts, catheter gauge and dwell time.
Results:
Childbearing women were, on average, aged 31 with body mass index (BMI) above 28. Women reported a mean pain score of 3.3/10 at 24 h for catheter insertion and 12% reported bruising. An 18-gauge catheter was considered more painful than a 16-gauge, and multiple attempts did not increase perceived average pain score. Association between failed first attempts and higher BMI was not established. Participant clinicians were predominantly midwives, who selected and placed 18-gauge catheters mostly in hand or wrist (66%). Decision-making about site, catheter gauge, dressing and attempts varied. Thirty-four per cent attempted two to three times, despite regular practise. Confidence to reliably insert determined catheter gauge and almost half clinician participants cited hospital policy and preferred non-dominant arm as key reasons for the location of PIVC.
Conclusions:
Regular use of a large-gauge catheter is counter intuitive when placed in the small veins of the hand with extension tubing. More research is needed to promote best practice around gauge selection, site and women's experience.
Details
- Title
- Peripheral intravenous catheter management in childbirth (PICMIC): A multi-centre, prospective cohort study
- Authors
- Lauren Kearney (Corresponding Author) - University of the Sunshine Coast, Queensland, School of Nursing, Midwifery and Paramedicine - LegacyAlison Craswell (Author) - University of the Sunshine Coast, Queensland, School of Nursing, Midwifery and Paramedicine - LegacyDebbie Massey (Author) - University of the Sunshine Coast, Queensland, School of Nursing, Midwifery and Paramedicine - LegacyNicole Marsh (Author) - Royal Brisbane and Women's HospitalRachael Nugent (Author) - Sunshine Coast Hospital and Health ServiceCatherine Alexander (Author) - Caboolture HospitalCarmel Smitheram (Author) - Sunshine Coast Hospital and Health ServiceAnthea McLoughlin (Author) - Sunshine Coast Hospital and Health ServiceAmanda J Ullman (Author) - University of Queensland
- Publication details
- Journal of Advanced Nursing, Vol.77(11), pp.4451-4458; 8
- Publisher
- Wiley-Blackwell Publishing Ltd.
- Date published
- 2021
- DOI
- 10.1111/jan.14933
- ISSN
- 1365-2648
- Grant note
- NURTURE Seed Grant
- Organisation Unit
- School of Health and Behavioural Sciences - Legacy; University of the Sunshine Coast, Queensland; School of Nursing, Midwifery and Paramedicine - Legacy; School of Health - Nursing
- Language
- English
- Record Identifier
- 99543908902621
- Output Type
- Journal article
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- Domestic collaboration
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- Nursing
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