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An Explanatory Model of Vascular Access Care Quality: Results of a Cross-Sectional Observational Study
Sonia Casanova-Vivas1,2, María Luisa Ballestar-Tarín1,3, Pablo García-Molina1
1Nursing Department, Facultat d'Infermeria i Podologia, Universitat de València, 46010 Valencia, Spain.
Abstract:
The management of nursing care regarding patients' vascular access is a priority. This study determines the contribution of the variables involved in the quality of care and maintenance of vascular access (VA) devices in admitted patients in the Valencian Community.
Methods:
Using the STROBE statement, an observational, cross-sectional study was conducted on 1576 VA devices. Data were collected using the INCATIV Questionnaire. We performed a multivariate analysis of the questionnaire variables.
Results:
In total, 50% had a good or very good assessment of the VA condition. This was positively correlated with anatomical location, dressing type, dressing date record, use of needle-free connectors (NFCs), date of last dressing change, presence of phlebitis, visibility of the insertion site and characteristics of the dressing's condition (p < 0.001). The model indicated that the presence of phlebitis was the clearest predictor of a poor VA care assessment (OR = 20.579), followed by no visibility of the insertion site (OR = 14.209). Results also indicated that uncovered VA lumens or no NFCs used were related to a negative quality assessment.
Conclusion:
By managing and controlling these variables, the likelihood of providing optimal care is ensured. This enables the establishment of a standardised care approach for all nursing professionals and the building of a new quality indicator.
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