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Bridging Theory and Practice in Emergency Nursing: A Discussion Paper on Peripheral intravenous catheter Management
Joana Moreira Ferreira Teixeira1,2,3,4, Gillian Ray-Barruel5,6,7, Gisela Mosca Teixeira4,8
1School of Medicine and Biomedical Sciences (ICBAS), Porto University (UP), Porto, Portugal.
Introduction:
Nursing management of peripheral intravenous catheters remains suboptimal and often lacks integration with underpinning theory. Therefore, it is essential to reflect on the persistent gap between theory and practice to enhance patients' outcomes in this area.
Objectives:
To conceptually evaluate the integration of Tanner's Clinical Judgment Model using Chinn and Kramer's criteria, and to explore the integration of these two complementary frameworks with Kramer's Ways of Knowing for peripheral intravenous catheter decision-making and patient outcomes improvement in the emergency department.
Methods:
A discussion paper, using Tanner's Clinical Judgment and Chinn & Kramer's Models, to bridge theory and practice, in peripheral intravenous catheter management in the emergency departments, done in October 2024, through consensus among authors, in interactive rounds.
Results:
According to Chinn and Kramer's model, which advocates evidence-informed and theory-based practice, the absence of theory in nursing education and practice is detrimental to the discipline. Tanner's model supports the integration of evidence into practice, and Chinn and Kramer's framework guides nurses in refining their decisions. In deciding whether to insert a peripheral intravenous catheter, emergency department nurses engage in cognitive and reflective processes, consult evidence-based guidelines, and integrate empirical evidence with personal and ethical considerations to ensure technically sound, empathetic, and ethically grounded patient care.
Conclusions:
This article analyses and promotes critical reflection on advanced practice nursing decision-making in the emergency department, exemplified by the holistic, evidence-informed processes that nurses use in peripheral intravenous catheter management. Future research is needed to evaluate the effectiveness of these models in education and clinical reasoning in specific emergent situations.
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