Aligning peripheral intravenous catheter quality with nursing culture-A mixed method study

Area of Science:

• Nursing Science
• Patient Safety
• Healthcare Quality Improvement

Background:

• Adherence to evidence-based guidelines for peripheral intravenous catheter (PIVC) care is essential for preventing complications.
• Variability in PIVC care quality exists across different hospital settings, necessitating an understanding of influencing factors.
• Previous research has not fully explored the nuanced barriers and facilitators affecting PIVC care adherence in diverse wards.

Purpose of the Study:

• To investigate the barriers and facilitators influencing adherence to PIVC care guidelines.
• To explore how different hospital ward cultures impact the quality of PIVC care.
• To identify strategies for improving PIVC management and patient safety.

Main Methods:

• A sequential explanatory mixed-method study design was employed.
• Quantitative data were collected using the Peripheral Intravenous Catheter mini questionnaire (PIVC-miniQ) across 41 wards.
• Qualitative data from individual nurse interviews were integrated with quantitative findings using the Pillar Integration Process.

Main Results:

• Significant variation in PIVC care quality was observed across hospital wards.
• Ward culture emerged as a central theme influencing PIVC quality, impacting education and adherence to best practices.
• Key subthemes included deviation from best practice, gaps in education, inter-ward quality variation, and the importance of supportive leadership.

Conclusions:

• Ward culture is a critical determinant of PIVC quality, with deviations linked to complications.
• Nursing education for PIVC management is heavily reliant on clinical placements, highlighting an educational gap.
• Improving PIVC care requires addressing educational deficits, fostering supportive leadership, and appointing ward champions.