Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

The Patient Experience of a Peripherally Inserted Central Catheter (PICC): A Qualitative Descriptive Study

Academic journal article Contemporary Nurse : a Journal for the Australian Nursing Profession

The Patient Experience of a Peripherally Inserted Central Catheter (PICC): A Qualitative Descriptive Study

Article excerpt

Peripherally inserted central catheters (PICCs) are vascular access devices used for medium to longer term treatment for a range of patient groups including those receiving chemotherapy and intravenous antibiotics. Traditionally PICCs were inserted by Interventional Radiologists; currently most PICCs are inserted by specially trained Registered Nurses (Moureau, 2006). These devices are often inserted for patients that undertake out of hospital or outpatient intrave- nous therapy (Caplan, 2012; Hitchcock, Jepson, Main, & Wickens, 2009). These patients can have PICCs for weeks to many months, and on the whole self-manage the device at home. Their con- tact with clinicians varies depending on the treat- ment plan; some see clinicians daily, for others it may be less frequently.

The insertion of a PICC can have a significant impact on the lives of patients. For example, arm choice for PICC insertion (whether the patient's dominant or non-dominant arm is used) can impact on the person's activities of daily living. While insertion practices differ across practice set- tings, selection of which arm to insert the cath- eter is most often determined by the clinician with little input from the patient. Whilst clinical factors including vasculature and skin integrity assessment may determine which arm is used for insertion, often arm choice is pre-determined and is based on institutional norms or clinician con- venience. Frequently, PICCs are inserted on the right side due to ease of insertion for the clini- cian, regardless of patient arm dominance (Sperry, Roskos, & Oskoui, 2012). In other clinical settings, the non-dominant arm is used based on the perceived ease of self-care for the consumer (Philpot & Griffiths, 2003).

From the perspective of the patient as a con- sumer, there are no published studies that have addressed the patient's view of arm choice for PICC insertion and impact of that choice on activ- ities of daily living. In fact, there are few studies that have explored the patient experience of living with a PICC. There is a need to determine the patient experience of a PICC to provide clinicians with an understanding of the consumer's perspec- tive of living with this device in situ and managing self-care. Understanding the person's perspective of health care is a fundamental requirement of contemporary health service delivery and central to patient-centred care (Pelzang, 2010).

Most research exploring the patient experi- ence of PICC insertion and impact of the device on daily life has focussed on patients with a malignancy (Molloy, Smith, & Aitchison, 2008; Nicholson & Davies, 2013; Oakley, Wright, & Ream, 2000). This research has been undertaken in oncology units in the United Kingdom (UK) in which participants received chemotherapy as out- patients. Although participants generally described satisfaction with the service and ability to be dis- charged home for treatment, they reported initial problems with undertaking activities of daily liv- ing including showering when self-managing at home (Molloy et ah, 2008; Oakley et al., 2000).

The quality and quantity of information pro- vided to patients was also identified as problem- atic (Molloy et al., 2008; Oakley et ah, 2000). In these studies, difficulties were identified with the volume and complexity of information pro- vided to participants, who were also found to be unable to retain much of the education provided to them. This is unsurprising as the provision of information about the PICC was in addition to information about diagnosis and the need for chemotherapy (Molloy et ah, 2008; Oakley et ah, 2000). This was in contrast to a more recent study that found no such problems with the informa- tion provided to a group of oncology patients (Nicholson & Davies, 2013). The participants' attitude towards the PICC also varied, with some viewing the device as the first step to treatment and cure, and others feeling that it was a reminder of their disease (Molloy et al. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.