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Exploring Australian emergency department clinicians' knowledge,attitudes and adherence to the national peripheral intravenous catheter clinical care standard: A cross-sectional national survey
Authors:Hui Xu PhD  Claire M Rickard PhD  Mari Takashima MD  Michael Butterfield BD  Edward Pink BD  Amanda J Ullman PhD
Affiliation:1. NHMRC Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia;2. NHMRC Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia

Metro North Health and School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia;3. School of Medicine, Centre for Applied Health Economics, Griffith University, Brisbane, Queensland, Australia;4. Emergency Department, Logan Hospital, Queensland Health, Brisbane, Queensland, Australia;5. Emergency Department, Queen Elizabeth II Jubilee Hospital, Queensland Health, Brisbane, Queensland, Australia;6. NHMRC Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia

School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia

Children's Health Queensland Hospital and Health Service, Brisbane, Queensland, Australia
Abstract:

Objective

This study aimed to (i) capture clinicians' knowledge, attitude and adherence to the first Australian national peripheral intravenous catheter (PIVC) Clinical Care Standard, (ii) examine the instrument performance of the knowledge related questions and (iii) explore the educational needs for, and barriers to, Standard adherence among Australian ED clinicians.

Methods

A cross-sectional national online survey was conducted from March to June 2022, using a snowball sampling method. The survey used 5-point Likert scales and multiple-choice questions to capture respondents' knowledge, attitude and adherence to the Standard as well as the educational needs for, and barriers to, Standard adherence.

Results

In total, 433 ED nurses and doctors responded. Although nearly half (n = 206, 47.6%; 95% confidence interval [CI] 55.5–65.8) of respondents claimed that they were unfamiliar with the Standard, questions on PIVC knowledge yielded that most respondents had adequate knowledge of most of the key standards. Respondents' attitudes towards multiple intravenous insertion attempts and ongoing PIVC competency monitoring are not in agreement with the Standard. Self-reported practices regarding routine insertion of idle catheters (55%; 95% CI 49.9–59.9), using antecubital fossa as the first insertion site (84%; 95% CI 80–87), insertion without confidence (46%; 95% CI 41.2–51.1) and lack of routine reviewing the ongoing needs of PIVC (40%; 95% CI 35.3–45.1) were not aligned with the Standard. Unawareness of the Standard and non-practical recommendations were rated as the top barriers to Standard adherence.

Conclusion

The findings of the survey suggest that the Standard may need modification to align with the needs of ED clinicians. Future studies need to explore the applicability and relevancy of some recommendations in the ED settings as they may cause low adherence to the Standard.
Keywords:adoption  attitude  emergency department  guideline adherence  knowledge  peripheral intravenous catheter
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