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
11/2021
PMID: 34118163
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Source: InCites
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
- Creators
- Lauren Kearney - University of the Sunshine CoastAlison Craswell - University of the Sunshine CoastDebbie Massey - University of the Sunshine CoastNicole Marsh - Royal Brisbane and Women's HospitalRachael Nugent - Sunshine Coast Hospital and Health ServiceCatherine Alexander - Metro North Hospital and Health ServiceCarmel Smitheram - Sunshine Coast Hospital and Health ServiceAnthea McLoughlin - Sunshine Coast Hospital and Health ServiceAmanda Ullman - University of Queensland
- Publication Details
- Journal of Advanced Nursing, Vol.77(11), pp.4451-4458
- Publisher
- Wiley-Blackwell Publishing Ltd.
- Number of pages
- 8
- Grant note
- NURTURE Seed Grant
- Identifiers
- 991012978826802368
- Academic Unit
- Faculty of Health; Nursing
- Language
- English
- Resource Type
- Journal article