Assessing nursing students' knowledge and skills in performing venepuncture and inserting peripheral venous catheters

Evaluating Nursing Students' Venipuncture and Peripheral Intravenous Cannulation Knowledge, Attitude, and Performance: A Two-Phase Evaluation Study

Peripheral intravenous cannulation and venipuncture are among the most common invasive procedures in health care and are not without risks or complications. The aim of this study was to evaluate the current training provided to nursing and midwifery undergraduate students. Student knowledge, attitude, practice, and performance regarding these procedural skills were assessed. A knowledge, attitude, and practices survey was disseminated to final year nursing and midwifery students as the first phase of this study. For the second phase of the study, nursing students were video recorded and then observed performing the skill of peripheral intravenous cannulation in a simulated environment. Thirty-eight nursing and midwifery students completed the survey, and 66 nursing students participated in the observation study. Descriptive statistics were performed. The mean knowledge score was 7.2 out of 15.0, (standard deviation [SD] = 2.4), and the mean attitude score was 10.20 out of 18.00 (SD = 4.79). Qualitative data from the survey were categorized to demonstrate specific areas of focus for improving the training. The mean performance score was 16.20 out of 28.00 (SD = 2.98). This study provides valuable input to developing and enhancing evidence-based curricula. It can help educators and supervisors, in both academic and clinical settings, identify areas where clinical performance and education could be enhanced.

Registered Nurses' Knowledge of Intravenous Fluid Therapy at a Teaching Hospital in Namibia: A Cross-Sectional Survey

Introduction

Insufficient knowledge of intravenous fluid therapy is a significant challenge contributing to morbidity and mortality in hospitalized patients. Nurses play a critical role in evaluating patients' fluid and electrolyte balance as well as in restoring fluid levels. Various studies have indicated a deficiency in nurses' knowledge of intravenous therapy, yet this remains understudied in many settings, including Namibia.

Objectives

To assess nurses' knowledge of intravenous fluid therapy and to describe the variables associated with knowledge of intravenous fluid therapy at a teaching hospital in Namibia.

Methods

A cross-sectional online survey involving 164 nurses who were recruited using total population sampling. Data were collected between September and November 2021, using a self-administered 14-item validated tool (α = 0.8). Data analysis was conducted using SPSSv28.0 software.

Results

The majority of nurses (84%) in this study exhibited an insufficient level of knowledge regarding intravenous therapy, with only a minority (16%) demonstrating a moderately adequate understanding of intravenous fluid therapy. A significant positive correlation was found between educational qualification and knowledge of intravenous therapy (r = 0.21; p = .01).

Conclusion

The study's results indicate a worrying trajectory in nurses' knowledge of intravenous therapy. These findings underscore the need for hospitals to establish comprehensive training programs for nurses to guarantee the provision of secure and efficient intravenous therapy. Additional research is needed to investigate how educational qualifications impact patient outcomes related to intravenous therapy.

Systematic review: Self-efficacy and skill performance

AIM

The aim of this systematic review was to investigate the relationship between self-efficacy and skill performance in undergraduate student nurses.

BACKGROUND

Across higher education, self-efficacy is an important predictor of student success in skill-based learning. Nursing students are required to demonstrate skills prior to caring for hospitalized patients. Understanding the relationship between self-efficacy and nursing student skill performance may support patient safety.

METHODS

Following the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), a systematic search was conducted of four databases: CINAHL, Medline, Psychinfo, and Web of Science. Quantitative, peer-reviewed studies published in English were included with no limitation on year. Hands-on skill performance had to be performed in laboratory or simulation settings and evaluated by an expert. Identified studies were assessed for methodological rigor using Joanna Briggs Institute's Critical Appraisal Tools.

FINDINGS

A total of 2,450 items were identified by database search and screened, resulting in 20 eligible studies. Most of the studies included novice first- or second-year students. Self-efficacy was operationalized as either a general or skill-specific measure, while the type of skill and associated instrumentation varied widely. Sixteen (80%) of the included study reports showed weak to no correlation between self-efficacy and skill performance. The remaining 4 reports noted a moderate-to-strong relationship.

CONCLUSION

Our findings conflict with existing research in other higher education disciplines where self-efficacy is a significant predictor of performance success. Explanations for this contradiction likely center around how self-efficacy was operationalized and rigor of the included studies.

IMPLICATIONS FOR NURSING

Larger studies controlling for confounding variables are needed to understand this relationship with a goal of developing more consistent approaches to teaching and learning skills within prelicensure curriculums.

Undergraduate nursing students' knowledge and experience in infusion therapy and peripheral vascular acces

OBJECTIVES

to analyze the knowledge and experience of undergraduate nursing students regarding infusion therapy and peripheral vascular access.

METHODS

descriptive, cross-sectional, analytical study with 123 undergraduate nursing students who answered a semi-structured instrument.

RESULTS

the majority were women, with a median age of 51 years old; 87% considered the teaching received insufficient to perform in clinical practice. The mean overall knowledge score was 78.1 (SD± 8.97). The themes catheter flushing and lock (38.1%), catheter selection (34.2%), infusion equipment (30.9%) and insertion site (30.9%) presented a significant number of errors.

CONCLUSIONS

practical classes and execution of procedures in health services were predictors for a better knowledge about infusion therapy and vascular access by undergraduate nursing students.

Analysis of influencing factors on the duration of pediatric peripheral intravenous catheter

BACKGROUND

The application of peripheral intravenous catheter has been an effective guarantee for the success of pediatric therapy. We aimed to investigate the correlative factors that impacting the duration of pediatric peripheral intravenous catheter.

METHODS

From January 2017 to October 2017, 370 cases of pediatric patients in the First Hospital of Hunan University of Chinese Medicine were collected as the research object. Based on the indwelling time, the collected cases were divided into two groups, namely long time group (>72 h) and short time group (<72 h). The general data and laboratory test results of two groups were collected, and the correlation factors of indwelling time were analyzed by single factor and Logistic multiple factors.

RESULTS

As the results revealed that compared with short time group, patients in long time group had statistically significant differences in puncture site, phlebitis, extravasation of blood vessels, hemoglobin, white blood cells, platelets, and 75% ethanol sterilization (p < 0.05). Logistic multivariate analysis indicated that scalp puncture was the independent protective factors that affecting the duration of pediatric peripheral intravenous catheter. Moreover, phlebitis represented the independent risk factor that influencing the indwelling time of pediatric peripheral intravenous catheter. And the differences were statistically significant (p < 0.05).

CONCLUSIONS

Analyze factors influencing indwelling time of pediatric peripheral intravenous catheter and enhance the management of relevant factors are of great significance to prolong the indwelling time, reduce the pain of pediatric patients, and facilitate the clinical medication.

Nurse knowledge and confidence on peripheral intravenous catheter insertion and maintenance in pediatric patients: A multicentre cross-sectional study

PURPOSE

To examine nursing knowledge and confidence of peripheral intravenous catheter insertion and maintenance in pediatric patients.

DESIGN AND METHODS

An online survey using validated questionnaires was conducted in ten (tertiary and district) hospitals in Indonesia from May to September 2020. Multivariable general linear models were used to investigate associations between nurses' characteristics and knowledge and confidence on the catheter insertion and maintenance score.

RESULTS

A total of 413 out of 458 pediatric nurses completed the survey (a response rate of 90%). The mean score of the nurse knowledge on insertion was 18.9(±3.3) (maximum score: 21), and the maintenance score was 6.5(±2.0) (maximum score: 12). The median score of the nurse insertion and maintenance confidence was quite high: 44 (IQR = 7) out of 50 and 37 (IQR = 4) out of 45, respectively. Initial patient assessment, catheter securement, site assessment and management of complications are areas where nurse knowledge and confidence are still lacking. Adjusted analysis indicates that training and work experience were significantly associated with the knowledge and confidence score (p < 0.05).

CONCLUSION

Pediatric nurses were largely confident in their skills but this was not reflected in their knowledge scores. Training and experience were important predictors for nursing knowledge and confidence in catheter insertion and maintenance.

PRACTICE IMPLICATIONS

The results provide nursing and hospital managers and educational institutions to understand areas of intravenous catheter insertion and maintenance in which nurses lack of knowledge and confidence as well as to formulate tailored and ongoing training to improve nurse knowledge, confidence, practices and optimize patients' care.

Evidence of learning on the insertion and care of peripheral venous catheters in nursing students: A mixed study

OBJECTIVES

1) To assess nursing students' evidence-based knowledge on the use of PVCs, and 2) to examine the perception of learning and teaching strategies aimed at this skill.

BACKGROUND

Insertion and care of Peripheral Venous Catheters (PVCs) are essential skills in undergraduate nursing education. Appropriate knowledge of this skill is crucial to improve clinical practice and patient safety. Therefore, training becomes an enabler for safe practice.

DESIGN

A multi-centre convergent parallel mixed-methods.

SETTING AND PARTICIPANTS

A total of 675 second-, third- and fourth-year nursing students from 3 nursing schools took part in the study.

METHODS

Quantitative data collection used a validated 15-question survey on knowledge of PVC management, and a descriptive and inferential analysis was carried out. Qualitative data were collected via a questionnaire consisting of 4 open-ended questions assessing knowledge, teaching methodologies and scenarios, and points for improvement.

RESULTS

Most participants were female (74.04%), with a mean age of 22.45 (SD = 4.65), who had no experience in the health field (61.8%). They obtained a mean knowledge score of 7.27 (SD = 2.64) out of 15. The students who obtained higher scores had a mean professional experience of 7.96, SD = 2.66 (p 0.000) and were in their final year, with a mean of 8.59, SD = 2.56, (p 0.000). On the other hand, the students assessed their knowledge as basic but improving year by year. They also identified a need to apply more active and experiential methodologies that would allow for reflection.

CONCLUSION

Level of educational level and experience is associated with increased knowledge. In order to improve knowledge, changes must be made in the training process to incorporate methodologies such as simulation and online training. There is a need to develop programmes that favour the alignment of theory with clinical practice.

Effectiveness of simulation-based peripheral intravenous catheterization training for nursing students and hospital nurses: A systematic review and meta-analysis

BACKGROUND

Peripheral intravenous catheterisation (PIVC) is a complex procedure.

AIM

This study reviewed studies evaluating the effects of different simulators in comparison with traditional methods used in PIVC training for nursing students and hospital nurses.

DESIGN

A systematic review and meta-analysis of randomised (RCT) and non-randomised controlled (N-RCT) studies.

METHODS

MEDLINE, Cochrane, Scopus, ERIC, Web of Science, and ScienceDirect were searched using PIVC, simulation and nursing education. The quality of evidence was assessed using the GRADE system; the risk of bias was assessed using the RoB 2 (for RCTs) and A Cochrane Risk of Bias Assessment Tool for N-RCTs. The study was conducted as per the PRISMA guidelines.

RESULTS

In total, 2,812 records were identified, and 12 studies published between 2002 and 2018 were finally included. Most studies included Virtual IV simulator and the plastic IV arm model in PIVC training for hospital nurses and nursing students, reported on outcomes such as PIVC-related knowledge, skills, confidence, state/trait anxiety and satisfaction. Seven studies were included in the meta-analysis, the effect sizes for all the outcomes ranged from small to moderate. However, the effect sizes were non-significant for all outcomes. The quality of evidence was assessed as being low for skills, knowledge, satisfaction, and trait/state anxiety, and moderate for confidence.

CONCLUSIONS

The effect of Virtual IV training on PIVC-related skills, knowledge, satisfaction and anxiety among nursing students and hospital nurses, in comparison with the plastic arm training method, remains unclear. However, Virtual IV training was found to increase PIVC confidence.

RELEVANCE TO CLINICAL PRACTICE

There is a small effect in favour of VR in PIVC education although non-significant. More evidence is needed to determine the superiority of simulation methods. In PIVC training of nurses and nursing students, hospitals and schools can choose a method in accordance with their resources.

TRIAL REGISTRATION

PROSPERO 2019 CRD42019124599.

The Predictive Strength of Students' Self-Efficacy, Problem Solving Skills to Perform Catheter Care

PURPOSE

The aim of this study was to determine the predictive strength of students' self-efficacy, problem-solving skills, and other characteristics in performing intravenous practices and monitor phlebitis and infiltration.

METHODS

This cross-sectional study was carried out with 736 third and fourth-year students studying at the Health Sciences Faculties of Balikesir and Sakarya universities. The data were collected using the Self-Efficacy Scale, Problem-Solving Inventory and Catheter Care and Infiltration Monitoring Questionnaire.

RESULTS

The participants' mean Catheter Care and Infiltration Monitoring Questionnaire score significantly and positively correlated with their mean Self-Efficacy Scale score on a moderate level (r=.25; p <.001) but significantly and negatively correlated with their mean Problem-Solving Inventory score on a moderate level (r=-.21; p <.001). In other words, because a low Problem-Solving Inventory score indicates that the person's problem-solving skill is high, the Care and Infiltration Monitoring Questionnaire score increased as the problem-solving skill increased. While the Self-Efficacy Scale predicted the year of study and catheter care and infiltration monitoring variables positively, the Problem-Solving Inventory predicted the satisfaction with the profession variable negatively.

CONCLUSION

Self-efficacy, problem-solving, liking the profession, and year of study predict success in catheter care and infiltration monitoring. For this reason, guidance may be provided in the development of a comprehensive education system toward increasing students' problem-solving skills, self-efficacy, and professional knowledge and skills.

Metodologias ativas no cateterismo periférico venoso: desenvolvimento de habilidades com simulador de baixo custo

RESUMO Objetivo Conhecer a percepção de estudantes de enfermagem sobre a contribuição do uso do simulador de baixo custo no desenvolvimento de habilidades técnicas para o cateterismo periférico venoso. Método Estudo descritivo de abordagem qualitativa, realizado em universidade pública do sul do Brasil com 25 estudantes de enfermagem. Os dados foram coletados em 2019, por meio de questionário acerca do cateterismo periférico venoso, desenvolvido com apoio de simulador de baixo custo. Para análise, seguiu-se a proposta operativa de Minayo. Resultados A partir dos dados, surgiram duas categorias. 1) Desenvolvimento de habilidades para cateterismo periférico venoso: os estudantes apontaram que o uso do simulador possibilita compreender cada etapa do procedimento e identificar onde precisam aperfeiçoar a técnica, preparando-os para o contato com o paciente. 2) Dificuldades encontradas na utilização do simulador de baixo custo. Os estudantes destacaram a baixa fidelidade do simulador e a limitação do treinamento por simulação sem comunicação. Conclusões e implicações para a prática Os estudantes percebem o simulador de baixo custo como uma relevante ferramenta para o desenvolvimento de habilidades do cateterismo periférico venoso, sugerem seu aperfeiçoamento para aumentar a fidelidade e a incorporação da comunicação no momento da punção para o maior realismo da experiência simulada.

Developing an Innovative Medical Training Simulation Device for Peripheral Venous Access: A User-Centered Design Approach

Nurses and other health students may lack the proper time for training procedural tasks, such as peripheral venous access. There is a need to develop these abilities in novices so that errors can be avoided when treating real patients. Nonetheless, from an experiential point of view, the simulation devices offered in the market do not always make sense for educators and trainees. This could make the adoption of new technology difficult. The purpose of this case study is to describe the development of an innovative simulation device and to propose concrete tactics for the involvement of the educators and trainees. We used a participative design based approach, with an ethnographic basis, where incremental cycles of user testing, development and iteration were involved. The study showcases methods from the field of design and anthropology that can be used to develop future simulation devices that resonate with students and educators to achieve a long term learning experience. Results could shed a light on new ways for the involvement of educators and students to create devices that resonate with them, making learning significant and effective.

Nursing students' knowledge on the management of peripheral venous catheters at Wollega University

BACKGROUND

Adherence to the best standards of nursing practice is the fundamental principle to improve patient outcome and prevent nursing procedure related-infections. A peripheral venous catheter (PVC) is the most common invasive procedure performed in nursing care. Its poor performance could expose patients to bloodstream-related infections. The present study aimed to assess post-basic nursing students' knowledge of evidence-based guidelines on the management of peripheral venous catheters.

METHODS

A cross-sectional study design was conducted on May 01-03, 2019, using a convenient sample 239 among post-basic nursing students in Wollega University.

RESULTS

The study result showed that nursing students' had a low mean (4.1±1.52) of knowledge about PVC procedure management. Only 41% of the respondents have adhered to recommendations of CDC guidelines. Among the provided options of the items, none achieved 100% correct answers. The majority of nursing students (77%) responded that antiseptic handwashing is always performed before insertion of PVCs. Meanwhile, few students (5%) correctly answered that the infusion set is recommended to be removed after 96 hours when neither lipids nor blood products are administered. In multivariable regression analysis, nursing students who had received training (AOR = 2.9, 95% CI (1.6, 5.1)) and who were younger (AOR = 2.4, 95% CI (1.3, 4.3)) significantly associated with a higher score of knowledge.

CONCLUSIONS

This study finding shows that an overall level of knowledge of post-basic nursing students is inadequate. Measurements such as an increase in the provision of adequate training by nurses educators based on evidence-based guidelines could improve the post-basic nursing students' knowledge.

Peripheral Venipuncture Education Strategies for Nursing Students: An Integrative Literature Review

This integrative literature review identified strategies to teach peripheral venipuncture to nursing students. The following databases were searched for primary studies: Biblioteca Virtual em Saúde (BVS), PubMed, Web of Science, Education Resources Information Center (ERIC), SCOPUS, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). The final sample was composed of 24 studies. The literature ranged from descriptive studies to controlled clinical trials and methodologic studies to construct products/instruments for teaching peripheral venipuncture. The most frequently identified teaching strategies were theoretical contents taught via theoretical lecture, e-learning courses, video lessons, and demonstration by specialists combined with practical exercises using a mannequin, human arms, and/or haptic devices. Despite the different methods used currently, the best patient outcomes were achieved when the student received the theoretical content in an educational setting before the practical training on a mannequin and/or a virtual simulator.

Hypermedia on peripheral venipuncture: effectiveness in teaching nursing students

OBJECTIVE

To assess the effectiveness of an educational hypermedia in the knowledge of Nursing academics on peripheral venipuncture.

METHOD

Quasi-experimental study with pre and post-test design.

RESULTS

The mean number of right answers of the 73 individuals who participated in the study, in the pre-test, was 7.7 (DP = 1.05), and 8.3 in the post-test (DP = 0.74). The comparation of pre and post hypermedia mean number of right answers showed significant difference (p < 0.001).

CONCLUSION

Hypermedia is a strategy that increases knowledge and is feasible in the teaching-learning process, being useful as a support tool for teachers and for the development of undergraduate Nursing students.

Assessing nursing students' knowledge of evidence-based guidelines on the management of peripheral venous catheters: A multicentre cross-sectional study

BACKGROUND

Inserting Peripheral Venous Catheters (PVCs) is one of the most routinely performed invasive procedures in nursing care and, if not well managed, it could expose patients to bloodstream-related infections. Knowledge of guidelines for the management of PVCs is fundamental to arise nurses and nursing students (NSs)' awareness on the importance of recommendations' adherence for clinical practice improvement.

OBJECTIVE

To determine NSs' theoretical knowledge of evidence-based guidelines for management of PVCs and investigate potential predictive factors associated to recommendations' adherence.

DESIGN

Cross-sectional.

SETTINGS

The study was carried out (March-September 2015) in seven Universities of three Regions of Italy (Marche, Abruzzo, Emilia Romagna).

PARTICIPANTS

A convenience sample of NSs (n = 1056) was involved.

METHODS

We collected data using a 10-items validated questionnaire assessing: knowledge of NSs' PVC guidelines and socio-demographic characteristics of the sample.

RESULTS

Most participants were female (74.8%), mean age: 22.4 years (DS = 3.9); attending the first, second and third year of Bachelor in Nursing (34.8%; 32.9%; 32.3%, respectively); with at least one year of training experience (32.1%). Most of incorrect answers given by NSs concerned the right way to wash hands before CVPs insertion (33.5%); the replacement of administration set <24 h when neither lipid emulsions nor blood products have been infused (79.7%); the choice of dressing to cover insertion site (59.3%); the use of steel needles to administer drugs (60.9%); the use of antibiotic ointment (68.7%); the correct concentration of chlorhexidine before PVCs' insertion (70.7%). In multivariate analysis, a higher level of education and an increased number of years of training experience and wards attended, were associated with better test scores. "Infusionset removal after 24 h when lipids or blood products are administered" (75.4%).

CONCLUSIONS

NSs' overall level of knowledge to some recommendations is inadequate. Nurse educators should emphasize on the importance of Evidence-based guidelines' knowledge in order to promote the translation of theory into practice of NSs.