A snapshot of guideline compliance reveals room for improvement: a survey of peripheral arterial catheter practices in Australian operating theatres

Reynolds, Heather, Dulhunty, Joel, Tower, Marion, Taraporewalla, Kersi and Rickard, Claire (2013) A snapshot of guideline compliance reveals room for improvement: a survey of peripheral arterial catheter practices in Australian operating theatres. Journal of Advanced Nursing, 69 7: 1584-1594. doi:10.1111/jan.12018

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Author Reynolds, Heather
Dulhunty, Joel
Tower, Marion
Taraporewalla, Kersi
Rickard, Claire
Title A snapshot of guideline compliance reveals room for improvement: a survey of peripheral arterial catheter practices in Australian operating theatres
Journal name Journal of Advanced Nursing   Check publisher's open access policy
ISSN 0309-2402
1365-2648
Publication date 2013-07
Year available 2012
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1111/jan.12018
Open Access Status
Volume 69
Issue 7
Start page 1584
End page 1594
Total pages 11
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell
Collection year 2013
Language eng
Formatted abstract
Aim. To report a study in Australian operating theatres of compliance by the anaesthetic team with best peripheral arterial catheter practice for blood gas sampling and infection prevention. Comparisons are made with research recommendations and Centres for Disease Control Guidelines.

Background. There is wide global usage of peripheral arterial catheters in the operating theatre for haemodynamic monitoring and blood gas analysis. Frequent blood sampling from arterial catheters can lead to statistically significant blood loss and provide an infective potential. Evidence-based research and clinical guidelines prescribe best practice.

Design. Cross-sectional descriptive survey

Methods. Data were collected in 2009 from 64 major Australian hospitals using a self-designed internet survey.

Results/Findings
. Hand hygiene prior to catheter insertion was the only infection prevention practice entirely adherent with guidelines. The recommended ratio of discard to dead space volume of 2:1 to decrease unnecessary blood loss during blood gas sampling was reported by only 11 (17%) respondents. Less than 32 (50%) respondents used the preferred solution, chlorhexidine to disinfect the insertion site. Access ports were reported as ‘never disinfected’ before use by 30 (47%) respondents.

Conclusion
. The complex operating theatre environment presents barriers, which contribute to non-adherence with guidelines. These barriers need to be identified to plan strategies for improvement. A quality audit tool is proposed for development by nurses in collaboration with the anaesthetic team, providing a needed method to assess ongoing compliance with best peripheral arterial catheter care. Further international research would test the generalizability of our Australian findings.
Keyword Anaesthesia
Clinical guidelines
Infection control
Theatre nursing
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Early view article first published online: 26 SEP 2012

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2013 Collection
School of Medicine Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 4 times in Thomson Reuters Web of Science Article | Citations
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Created: Wed, 05 Dec 2012, 17:10:12 EST by Sia Athanasas on behalf of Anaesthesiology and Critical Care - RBWH