Dressing and Securement of Peripheral Arterial Catheters: A Pilot Randomised Controlled Trial

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Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing and Midwifery
Griffith Health
The purpose of this research was to assess the feasibility of the trial design and elements for future extensive study to provide evidence of the effectiveness of novel dressing/securement technologies to prevent catheter failure in peripheral arterial catheters in a larger research setting. Peripheral arterial catheters are a type of intravascular catheter that is widely used in the care of critically ill patients. The catheter insertion site is usually covered with a commercially produced transparent dressing to maintain the position of the catheter, as well as endeavouring to prevent microbial entry to the wound. Arterial catheters may accidentally fall out, become blocked, or become infected, causing catheter failure, interrupted therapy, painful reinsertion, and decreased patient satisfaction. The infection risks of arterial catheters have often been underestimated. Inadequate peripheral intravascular catheter securement remains a poorly researched area of patient care, with a paucity of quality studies. Improved securement would likely prevent many cases of catheter failure. The aim was to determine initial effectiveness of one dressing and two securement methods with the potential to minimise failure in peripheral arterial catheters compared with usual care, in a pilot study. Specified feasibility objectives for this pilot trial were to be considered successful if 90 out of 120 patients (75%) fulfilled the feasibility criteria regarding recruitment, delivery and adherence, retention, and patient/staff satisfaction with the study products. This would show that the research methods were suitable for use in a larger trial.