Related Experiment Video
Updated: Jun 14, 2026
09:57
A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
Published on: July 13, 2019
Nurses' Clinical Decision-Making During Peripherally Inserted Central Catheter Dressing Application and Removal: A
Emily N Larsen1, Jane Wickins2, Nicole Marsh2
1School of Nursing and Midwifery, Griffith University, Nathan, Australia; Nursing and Midwifery Research Centre, Royal Brisbane and Women's Hospital, Herston, Australia.
Seminars in Oncology Nursing
|June 12, 2026
Summary
Cancer care nurses use a mix of intuitive and analytical thinking for Peripherally Inserted Central Catheter (PICC) dressing and securement. Improving practice requires education, reflective support, and evidence-based ward culture.
Area of Science:
- Nursing
- Oncology Nursing
- Clinical Decision-Making
Background:
- Peripherally Inserted Central Catheter (PICC) lines are crucial in cancer care.
- Effective application and removal of PICC dressings and securement devices are vital for patient safety and treatment continuity.
- Understanding the cognitive processes underlying nursing practice in this area is essential for optimizing patient outcomes.
Purpose of the Study:
- To investigate the clinical decision-making and reasoning of nurses during Peripherally Inserted Central Catheter (PICC) dressing and securement procedures.
- To explore the cognitive strategies employed by nurses in cancer care settings.
- To identify factors influencing these decisions, including patient needs and environmental context.
Main Methods:
- A qualitative study utilizing the Think Aloud method with registered nurses in adult and paediatric cancer care wards.
- Participants (n=14) engaged in one-on-one sessions involving PICC dressing and securement application and removal.
- Data were analyzed using Framework Analysis and mapped against Dual Process Theory (System 1 intuitive vs. System 2 analytical thinking).
Main Results:
- Five themes emerged: Education and Value, Rituals and Culture, Product Familiarity, Anticipatory Assessment and Planning, and Thoughtful Practice.
- Intuitive thinking dominated routine actions, influenced by ward culture and product familiarity.
- Analytical thinking was observed in deliberate decision-making, particularly for patient-specific needs like skin integrity and preferences. Mixed processes were noted in planning.
Conclusions:
- PICC dressing and securement involve complex nursing decision-making, utilizing diverse cognitive strategies.
- Findings underscore the need for targeted nursing education and structured support for reflective practice.
- Fostering an evidence-based ward culture is crucial for consistent, high-quality PICC care.
Related Concept Videos
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
Parenteral Nutrition (PN) delivers essential nutrients directly into the bloodstream, bypassing the digestive system. It is commonly used for individuals with severe digestive disorders or conditions that prevent normal nutrient absorption.
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
01:26Cardiac Catheterization IV: Nursing Management
Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
01:29Endocarditis IV: Nursing Management
Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
01:26Peripheral Artery Disease IV: Nursing Management
The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses, temperature changes,...
01:25Peritoneal Dialysis III: Nursing Management
Peritoneal dialysis, or PD, utilizes the peritoneal membrane as a filter to eliminate excess fluid and waste products. Effective nursing management is essential for ensuring patient safety, preventing complications, and promoting optimal function of the peritoneal dialysis process.Assessment and MonitoringNurses must thoroughly assess the patient before, during, and after each dialysis session. Regular monitoring includes vital signs, daily weight, fluid intake and output, and laboratory values...
01:23Peripheral Artery Disease V: Postoperative Nursing Management
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...