Survey for Insertion and Management of Peripheral Arterial Catheter in the Acute Care Unit

Abstract

Background: Arterial catheters are commonly used in acute care units for hemodynamic monitoring in conjunction with blood pressure and blood gas analysis. Complications arising from the use of arterial catheters have been reported; however, few studies have focused on standard practice of arterial catheters. Aim: To clarify the management, particularly the insertion frequency and timing, of peripheral radial arterial catheters in acute care units in Japan. Methods: We developed 34 questions through an interactive process based on guidelines and clinical experience to create a digital survey. This survey was conducted over a month. Participants were nurses working in acute care units in Japan who received electronically distributed surveys through nursing-specific mailing lists and social network services. Results: A total of 451 responses were collected; 224 were used for analysis. Respondents reported 35% implemented routine insertion of arterial catheters for all newly admitted patients, while 58% would insert the arterial catheter within 24 hours of admission.  Only 7% of respondents did not add heparin to the pressurized bag. Of the respondents, 51% had a rule to change the pressurized bag of fluids every 3 days. Splinting of the wrist was a routine procedure for 41% of respondents. Conclusions: Arterial catheters were commonly used in all acute care units.  Based on the results of the survey, we recommend the use of heparin as a flush fluid should be reconsidered. The high rate of unnecessary arterial catheter insertions and the routine use of splinting need to be reassessed.