Patient Perceptions and Experience of Pain, Anxiety and Comfort during Peripheral Intravenous Cannulation in Medical Wards: Topical Anaesthesia, Effective Communication, and Empowerment

摘要

Background : Peripheral intravenous cannulation (PIVC) is one of the most common invasive procedures that healthcare personnel perform daily, often a source of patients’pain, anxiety, dissatisfaction and discomfort. Despite the importance of increasing patient’s comfort in medical care, this need has being increasingly overlooked during PIVC, especially in the current busy clinical settings. Doctors and nurses play a significant role in providing effective, easy-to-implement pharmacological and non-pharmacological management to help patients cope with pain, distress, and anxiety in the frequently performed cannulation. Objective : To assess adult patient perceptions and experience of comfort, pain and anxiety during PIVC in medical wards. Design and Setting : A cross-sectional descriptive study was carried out on 120 adult patients admitted to medical wards. Methods: Patients aged 18 to 65 who had undergone PIVC for 24 to 48 hours, with an 18 gauge Vasofix cannula and were alert and conscious during cannulation were included in the study. The study was guided by Kolcaba’s Theory of Comfort. A structured face-to-face survey was used to collect data. Descriptive statistics were used to analyse the data. Results : One hundred and fourteen patients (95%) experienced pain and 88 patients (73.3%) reported anxiety during PIVC. Forty-seven patients (53.2%) stated that they were afraid of needle pain, 26 patients (30.2%) were afraid of staffs’ability during PIVC, and 12 (13.5%) were afraid of blood or bleeding. Ninety-two patients (76.6%) indicated that their healthcare professional only pricked them once during cannulation. Only a small number of patients (11.7%) were offered topical anaesthesia and very few patients (15.8%) were given the option to choose their preferred site for cannulation. The majority of patients, 110 (91.7%), expressed the need for topical anaesthesia and 116 patients (96.7%) reported effective communication for pain relief. One hundred and eighteen patients (98.3%) said they thought they would have been more comfortable if they had been able to choose the site for cannulation. Conclusion s : The results may raise awareness of the need to reduce patients’pain and anxiety during PIVC. Using both pharmacological and non-pharmacological approaches, including topical anaesthesia, effective communication (friendly and informative staff) and empowerment to choose the site for cannulation; patients will be more relieved and subsequently reduce negative experiences that aids recovery.