Conectar
To systematically map the landscape of central venous access device research from 2014 to 2024, identifying critical gaps in evidence that may impact nursing practice and patient outcomes across the full device lifecycle from selection through to removal.
This review was conducted in accordance with the Guidance for producing a Campbell evidence and gap map and reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.
PubMed, Cumulative Index to Nursing and Allied Health Literature Complete, Scopus, and Cochrane Central Register of Controlled Trials were systematically searched with additional hand-searching of reference lists from included reviews.
We systematically reviewed literature published between 2014 and 2024, mapping 710 studies on central venous access device interventions and outcomes. Studies were categorised by design, population, setting, device characteristics, intervention types, and outcomes. Evidence was evaluated using the National Health and Medical Research Council levels of evidence framework.
Of 710 included studies, 89 were systematic reviews and 621 primary studies, of which 41.1% (n = 292) were randomised controlled trials. Research was primarily conducted in high-income countries (n = 405, 65.2%) and focused on adults (n = 370, 59.6%) in hospital inpatient settings (n = 588, 94.7%). Catheter insertion and infection prevention dominated the evidence base, while device selection and removal procedures were less studied. Infection outcomes were extensively reported (bloodstream infection: n = 455, 13.6% of 3349 outcomes), while patient-reported outcomes (n = 218, 6.5%) and cost (n = 60, 1.8%) were underrepresented.
This review reveals that central venous access device research is predominantly focused on insertion and infection prevention while other key parts of nursing practice are under-supported.
Future nursing research should address these gaps to improve evidence-based care across diverse populations and healthcare contexts, particularly focusing on understudied device types, settings, and vulnerable populations.
This review was conducted and reported in accordance with the Guidance for producing a Campbell evidence and gap map.
This study did not include patient or public involvement in its design, conduct, or reporting.
To provide a contemporaneous evidentiary overview of neonatal and paediatric studies investigating alarm-related patient safety and alarm system management. Furthermore, to describe how clinical alarm burden is captured and reported, to identify clinical devices that contribute to alarm burden, to explore alarm-related and patient safety measures and terminologies and to review alarm management initiatives.
Scoping review.
A systematic search of PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Scopus and EBSCOhost was conducted from 2013 to 2023 using predetermined search terms, index terms, medical subject headings and truncation.
Observational and qualitative studies with neonatal and paediatric populations reporting monitoring and alarm practices; and interventional studies reporting the success of alarm safety interventions were included. The quality of the included studies was assessed using the mixed methods appraisal tool.
The search yielded 37 studies of acceptable quality. The majority explored alarm burden associated with physiological monitoring (n = 35; 95%). Alarm definitions were reported in 46% (n = 17) of studies, and commonly included what constituted actionable and non-actionable alarms. While 32% (n = 12) of studies considered alarms in relation to clinical outcomes surrounding patient safety, clinician response to alarms was only reported in 19% (n = 7) of studies. Alarm and monitoring interventions were assessed in 51% (n = 19) of included studies, with categorization into six domains: changing alarm parameters, clinician education, communication and planning, technology, alarm ordering and standardization or guidelines.
This review has demonstrated the enormity of alarms in clinical settings, heterogeneity of alarm definitions and outlined interventions associated with alarm burden and patient safety.
Strategies to ensure appropriate alarm limits are set and clinicians are empowered through education to recognize and respond appropriately to alarms can maximize patient safety.
This review adheres to the preferred reporting items for systematic reviews and meta-analysis protocols extension for scoping reviews.
No patient or public contribution.
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