Following a well-received presentation at the recent National Infusion and Vascular Access Society (NIVAS) Conference in June, Andrew Barton has subsequently published his research into Considering the Uncompliant Patient in Vascular Access in the British Journal of Nursing.
Here’s a summary of his findings:
Uncompliant patient groups:
- Intravenous drug users
- Patients with learning difficulties
- Needle-phobic patients
A 4-step approach is key to gaining trust from your uncompliant patient:
A topical anaesthetic, applied to the skin under a film dressing and left for at least 45 minutes. A further anaesthetic may be considered before insertion, depending on depth of the vessel, type of vascular access device and any prior agreement made with the patient.
2. Comfort / position
Ensure you and the patient are in comfortable positions to make a successful first attempt more likely.
This could be play therapy, talking, aromatherapy, reflexology or having a friend or relative distract them.
4. Vein-location technology
“I would always use ultrasound or infrared to locate a vessel….I would not advocate a blind attempt first, as you are more likely to fail and lose the trust of your patient.”
More from Andrew Barton:
Follow Andrew Barton on Twitter: @IV_Nurse