Discrepancies Between Patient-Reported Discomfort and Clinical Documentation in Postoperative Care of Central Venous Catheters After Surgery: A Prospective Descriptive Study.

BACKGROUND AND AIM: Central venous catheters are vital in the peri- and postoperative period for patients undergoing abdominal surgery but are associated with risks such as catheter related infections. Signs of infection, like tenderness and induration at the insertion site, are important to recognize, as they may precede catheter-related infections, but are often neglected. The aim was to compare surgical patients' experience of central venous catheter with the nursing documentation.

METHODS

Data was collected from short patient interviews and by reviewing electronic health record documentation.

RESULTS

In total, 106 patients were included, 103 of whom had a central venous catheter located in the internal jugular vein. The median (interquartile range) number of days with a catheter was 10 (8-16). There were no catheter related infections, but potential risks were identified. In 56% of the patients, central venous catheters were removed within the last 2 days before discharge. The most common reason for keeping the catheter was blood sampling. The results from the interviews indicate that 37 of the patients experienced considerable discomfort, such as persistent sensations of constriction, restricted mobility and pain, however, these symptoms were documented in the electronic health record for only three patients.

CONCLUSION

The findings emphasize the necessity of systematically addressing patients' symptoms and individual needs in the postoperative care of the central venous catheter. Incorporating these aspects as a mandatory element in the standardized documentation template within the electronic health record will constitute an important first step toward enhancing patient-centred care. There is a need for clearly defined guidelines outlining the indications for retention or removal of central venous catheters to minimize catheter-days during postoperative care in surgical wards.

TRIAL REGISTRATION: As this was a descriptive, qualitative observational study that did not involve testing a new intervention, compare interventions, or randomize participants, we did not find trial registration necessary under commonly accepted guidelines for clinical trial registration.