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Challenges for Nurses Caring for Individuals with Peripherally Inserted Central Catheters in Skilled Nursing Facilities
Author(s) -
Harrod Molly,
Montoya Ana,
Mody Lona,
McGuirk Helen,
Winter Suzanne,
Chopra Vineet
Publication year - 2016
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.14341
Subject(s) - medicine , preparedness , nursing , focus group , documentation , exploratory research , qualitative research , peripherally inserted central catheter , patient safety , health care , social science , catheter , surgery , marketing , sociology , political science , computer science , anthropology , economics , law , business , programming language , economic growth
Objectives To understand the perceived preparedness of frontline nurses (registered nurses ( RN s), licensed practical nurses ( LPN s)), unit nurse managers, and skilled nursing facility ( SNF ) administrators in providing care for residents with peripherally inserted central catheters ( PICC s) in SNF s. Design Exploratory, qualitative pilot study. Setting Two community based SNF s. Participants Residents with PICC s, frontline nurses ( RN s, LPN s), unit nurse managers, and SNF administrators. Methods Over 36 weeks, 56 residents with PICC s and their nurses were observed and informally interviewed, focusing on PICC care practices and documentation. In addition, baseline PICC data were collected on placement indication (e.g., antimicrobial administration), placement setting (hospital vs SNF ), and dwell time. Focus groups were then conducted with frontline nurses and unit nurse managers, and semistructured interviews were conducted with SNF administrators to evaluate perceived preparedness for PICC care. Data were analyzed using a descriptive analysis approach. Results Variations in documentation were observed during weekly informal interviews and observations. Differences were noted between resident self‐reported PICC concerns (quality of life) and those described by frontline nurses. Deficiencies in communication between hospitals and SNF s with respect to device care, date of last dressing change, and PICC removal time were also noted. During focus group sessions, perceived inadequacy of information at the time of care transitions, limited availability of resources to care for PICC s, and gaps in training and education were highlighted as barriers to improving practice and safety. Conclusion Practices for PICC care in SNF s can be improved. Multimodal strategies that enhance staff education, improve information exchange during care transitions, and increase resource availability in SNF s appear necessary to enhance PICC care and safety.