Factors influencing the optimal selection of central venous access devices:A qualitative study of health care team members’perspectives

医务工作者对合理选择中心静脉通路装置影响因素认知的调查

Objective:This study aimed to explore health care team members’understanding of the factors influencing the optimal selection of central venous access devices(CVADs).Methods:The data of the study was collected using semi-structured interviews.Twenty-six hospital medical staff(four hospital manager,15 head nurses,7 nurse)with experience in peripheral or central catheterization from four regions(Northern China,Southern China,Northwest China,and Qinghai-Tibet China)in China were interviewed between June and October 2021.Content analysis was used to analyze the data.Results:The results revealed five themes and 14 sub-themes.Patients:concerns,resources,requirements,and evaluation(security concerns,support resources,life requirements,evaluation among patients);nurses:awareness,knowledge,and popularizing methods(awareness of intravenous therapy,understanding of professional knowledge,forms of popularizing methods);doctors:support and involvement(support for decision-making,involvement in intravenous work);hospital managers:authority,quality control and continuing education(management of catheterization authority,quality control of intravenous infusion,investment in continuing education)and environment:differences and commonalities(differences in social support,and current commonalities).Conclusion:Nurses and other healthcare team members’understanding,selection,use,and recommendation of CVADs have an indirect effect on patients’decision-making.Therefore,hospital managers and government departments can indirectly strengthen medical team cooperation and improve learning education in order to improve the safety of patients receiving intravenous infusions.

目的探讨医务工作者对合理选择中心静脉通路装置影响因素的认知。方法采用半结构化访谈收集资料。2021年6月—10月对全国4个地理区域(南方、北方、西北及青藏地区)26名具有静脉治疗专业背景的人员(医院管理者4名,临床护士长15名,护士7名)进行访谈。采用内容分析法对资料进行分析。结果通过资料分析提炼5个主题及14个子主题。患者方面:信任、支持、需求和评价(安全性的信任度、就医能力的支持度、生活质量的需求度、患者间的信息评价);护士方面:观念、知识和健康教育方式(静脉治疗的观念,专业知识的掌握,健康教育的方式);医生方面:支持和参与(置管决定的支持度、静脉治疗工作的参与度);医院管理者:权限、质量控制和培训(置管权限的管理、静脉治疗质量控制力度、继续教育的投入);环境方面:差异和共性(社会支持的差异、普遍存在的问题)。结论医务工作者对中心静脉通路装置正确的认识、选择、使用和推荐可间接影响患者对输液工具的选择。这提示医院管理者和政府部门可通过优化学习培训形式、强化医疗团队合作等间接方式提升患者静脉输液治疗的安全性。