Central venous catheter exit site dressings: balancing patients' needs, nurses' experiences and the research evidence

Smyth, Wendy, McArdle, Joleen, and Gardner, Anne (2016) Central venous catheter exit site dressings: balancing patients' needs, nurses' experiences and the research evidence. Wound Practice and Research, 24 (1). pp. 41-46.

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Background/Aims: Many patients undergoing life-preserving haemodialysis are exposed to additional risks because access is via a central venous catheter (CVC). Despite a paucity of evidence, guidelines and policies dictated the use of transparent exit site wound dressings, which was contrary to local nurses' practice of using an opaque wound dressing. This study aimed to explore nurses' experiences with three types of CVC exit site dressings in the context of a randomised controlled trial (RCT).

Methods: A descriptive exploratory design was used. Transcripts from seven focus groups held with haemodialysis nurses were analysed thematically.

Results: Fifteen nurses, with varying haemodialysis experience, provided comments on the ease of applying and removing the dressings, problems encountered with the dressings, which dressing types they thought best or worst, and the value of having a specific work practice instruction developed for the RCT. It was clear that, although no dressing type was perfect, the opaque dressing was the best given the properties of the dressings, the patients' preferences, and the humid climate.

Conclusion: The perspectives voiced by the focus group participants support the need to modify the local health service's policy, in line with revised state and national guidelines for this type of patient cohort, to allow for individual, contextual and climatic considerations.

Item ID: 42184
Item Type: Article (Research - C1)
ISSN: 1323-2495
Keywords: intravascular device dressings; evidence-based practice; focus groups; patient comfort; tropical weather; haemodialysis
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Funders: Queensland Health Office of the Chief Nursing Officer, Townsville Hospital and Health Service Private Practice Research and Education Trust Fund
Projects and Grants: Novice Nurse Researcher Grant 2009
Date Deposited: 25 Jul 2016 22:44
FoR Codes: 42 HEALTH SCIENCES > 4205 Nursing > 420501 Acute care @ 100%
SEO Codes: 92 HEALTH > 9299 Other Health > 929999 Health not elsewhere classified @ 100%
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