Discrepancies between patient-reported discomfort and clinical documentation in postoperative care of central venous catheters after surgery
Maria Lithner, Adina Noghi, Thomas KanderAbstract
Introduction
Central venous catheters (CVCs) are vital during the perioperative and postoperative period for patients undergoing abdominal surgery, but they carry risks such as catheter-related infections. Early signs of infection, including tenderness and induration at the insertion site, are important to detect as they may precede infection; however, these symptoms are often overlooked. The aim of this study was to compare surgical patients’ experiences of having a CVC with corresponding nursing documentation.
Methods
Data were collected through brief patient interviews and a review of electronic health record (EHR) documentation.
Results
A total of 106 patients were included, of whom 103 had a CVC inserted in the internal jugular vein. The median number of catheter days was 10 (IQR 8–16). No catheter-related infections occurred, but potential risks were identified. In 56% of cases, the CVC was removed within the last 2 days before discharge, and the most common reason for catheter retention was blood sampling. Interview results showed that 37 patients experienced significant discomfort, including persistent sensations of constriction, restricted mobility, and pain. Despite this, these symptoms were documented in the EHR for only three patients.
Discussion
The findings highlight the need to systematically address patients’ symptoms and individual needs in postoperative CVC care. Integrating such assessments into mandatory fields within standardized EHR documentation templates may help promote patient-centred care. Additionally, clearly defined guidelines for when to retain or remove CVCs are needed to reduce unnecessary catheter-days in postoperative care.