A qualitative study of factors influencing evidence-based practice of blood collection by clinical nurses via central venous access devices

Abstract

Background:

Several studies have upheld the advantages of blood collection using via central venous access device (CVAD); the procedure has a high success rate and avoids painful repeated punctures. Some studies have suggested that via central venous access device (CVAD) blood collection is preferable for acute and critical care, oncology, and pediatric patients. However, there is no consensus on or standardization of this approach.

Purpose:

To explore the facilitators of and barriers factors of evidence-based decision-making in CVAD blood collection in clinical practice.

Methods:

This was a qualitative study guided by phenomenological research. A purposive sampling method was used to select 13 clinical nurses from two public hospitals in China to conduct semi-structured personal interviews. The interview outline was designed based on a literature review and the i-PARIHS theoretical framework, and information was organized and analyzed using the Colaizzi 7-step analysis method.

Results:

Two themes and seven sub-themes were derived from the analysis of interview data. Facilitating factors: (1) nurses’ trust the evidence-based nursing decisions; (2) low rate of operational complications; (3) high success rate of blood collection; (4) nurses’ sense of professional benefit; Hindering factors: (1) preparation of operational materials and time-consuming operation; (2) nursing interruptions; (3) patients’ economic factors. The interview data showed that CVAD blood collection is suitable for critically ill patients, children, patients with poor venous conditions and poor cooperation.

Conclusion:

This study provides guidance for advancing the clinical application of evidence-based CVAD blood collection. Evidence-based nursing culture, operational advantages, and nurses’ sense of professional benefit were effective facilitators of the evidence-based practice. Researchers need to optimize the operating materials and methods, and comprehensively consider multiple factors to promote the better application of evidence.

Keywords

Central venous access device blood collection evidence-based nursing decision influencing factors qualitative study

Get full access to this article

View all access options for this article.

References

Sun

Chen

Guo

, et al. Expert consensus on venous catheter maintenance. Chin J Nurs 2019; 54(09): 1334–1342.

Sun

Tang

Bian

Study on the application of push-pull (mixed) method for collecting routine blood specimens through peripheral venous puncture with central venous catheter placement. Gen Pr Nurs 2021; 19(05): 636–638.

Lalthanthuami

Kumari

Venkateswaran

, et al. Performance of 3 mL versus 5 mL discarded volume for blood sampling from central venous access device. J Lab Physicians 2021; 13(02): 112–117.

Zhang

Chen

, et al. Blood sampling from peripherally inserted central catheter is effective and safe for patients with head and neck cancers. J Vasc Access 2021; 22(3): 424–431.

Tang

Study on the effectiveness of blood collection via intravenous indwelling needle in patients staying in the emergency hospital for observation. Chongqing Medicine 2015; 44(14): 2009–2011.

McBride

Miller-Hoover

Proudfoot

JA.

A standard push-pull protocol for waste-free sampling in the pediatric intensive care unit. J Infus Nurs 2018; 41(3): 189–197.

Gorski

Hadaway

Hagle

, et al. Infusion therapy standards of practice, 8th edition. J Infus Nurs 2021; 44(1S Suppl 1): S1–S224.

Nickel

Gorski

Kleidon

, et al. Infusion therapy standards of practice, 9th edition. J Infus Nurs 2024; 47(1S Suppl 1): S1–S285.

Spina

Mussa

Tollapi

, et al. Adoption and application in Italy of the principal guidelines and international recommendations on venous access. Minerva Med 2018; 109(3): 153–202.

10.

Wyant

Crickman

Determining the minimum discard volume for central venous catheter blood draws. Clin J Oncol Nurs 2012; 16(5): 454–458.

11.

Lokeskrawee

Muengtaweepongsa

Patumanond

, et al. Accuracy of laboratory tests drawn by pull-push method from central venous catheterization after routine flushing with 10 ml normal saline in patients with sepsis at the emergency department. Heliyon 2021; 7(6): 347–355.

12.

Zhang

Qin

Chen

, et al. Summary of the best evidence for blood collection via central venous access devices. Chin J Nurs 2022; 57(09): 1134–1140.

13.

Zhang

A conceptual framework for clinical practice change:from PARIHS to i-PARIHS. Chin J Évid -med 2019; 19(06): 741–747.

14.

Liu

Nursing research methods. Beijing, China: People’s Medical Publishing House, 2018, pp. 115–118.

15.

Zhou

, et al. Best evidence summary of early exercise interventions for acquired debilitation in ICU. Chin J Acute Crit Care Nurs 2022; 3(04): 319–325.

16.

Chen

Wang

Huang

, et al. Summary of the best evidence for early muscle training in stroke patients. Chin J Nurs 2020; 55(08): 1253–1259.

17.

Qian

Zhou

Wang

, et al. Best evidence summary of oral hydration methods for the prevention of contrast nephropathy in patients after coronary intervention. Nurs Res 2020; 34(12): 2062–2067.

18.

Zhang

Yang

A qualitative study of factors influencing evidence-based practice of central venous catheter maintenance among emergency nurses. Chin J Acute Crit Care Nurs 2020; 1(04): 298–302.

19.

Wang

. A study on the impact of benefit discovery education on nurses’ sense of professional benefit. Nursing Research 2019; 33(24): 4363–4365.

20.

Zhang

Zhao

Progress of nursing research on blood collection in transvenous infusion catheters. J Nurs 2022; 37(24): 82–85