Factors Influencing Nurses' Use of Local Anesthetics for Venous and Arterial Access

Abstract

The use of local anesthetics to relieve pain associated with intravenous cannulation and arterial blood gas sampling is given low priority in many health institutions. This review sought to identify factors influencing nurses' use of local anesthetics for these procedures. The Database Syntax Guide for Systematic Reviewers was used; health-relevant studies were critically assessed with appropriate Critical Appraisal Skills Programme tools. Significant factors influencing the use of local anesthetics for parenteral procedures were identified, including the level of effectiveness among types of local anesthetics, the perceived benefits of facilitating needle insertions and patient satisfaction, the underestimation of pain associated with needle punctures, time concerns, physician authorization, and costs.

Modelling nurses’ use of local anaesthesia for intravenous cannulation and arterial blood gas sampling: A cross-sectional study

“…Most participants (about 85%) believed that doctors' orders to use LA is a factor that can facilitate its use for parenteral procedures. This finding is consistent with past literature showing that doctors' non-authorisation to use LA before parenteral procedures is a barrier to nurses' ability to provide optimal pain management (Czarnecki et al, 2011;Hudson et al, 2006;Papa and Zempsky, 2010;Alobayli, 2019). Furthermore, the path analysis showed that over 60% of nurses believed that doctors underestimate pain from IV cannulation and ABG procedures, which influenced their attitudes towards LA use.…”

“…This study's findings showed that most participants viewed the cost of LA as a factor influencing its availability in the hospital. This finding is consistent with research that identified that one reason for not using topical LA (EMLA cream) (prior to parenteral procedures) was that it was very costly (Burke et al, 2011;Alobayli, 2019). Therefore, this study considers that the cost of LA is important when summarising choices for its use in parenteral procedures because it can indeed be prohibitive to its use.…”

“…This result showed that nurses follow the hospital's policy as a legal requirement in their profession. The main issue in this study is that there is no hospital policy directing LA use for parenteral procedures (Alobayli, 2019). The path model also demonstrated that there is a large variation amongst the staff's beliefs as to whether LA use is acceptable or not.…”

“…Local anaesthetics (LA) are used to relieve pain associated with such procedures in many countries (Hudson et al, 2006;Jimenez et al, 2006). However, nurses in Saudi Arabia routinely perform the procedures without using LA, thus subjecting patients to unnecessary pain and anxiety (Alobayli, 2019). Their practices seem against evidence and recommendations regarding the effectiveness of LA for reducing procedural pain (Crowley et al, 2011;McGowan, 2014;Page and Taylor, 2010).…”

“…Pain management for minor procedures, such as IV cannulation and ABG, is low priority in many institutions in Saudi Arabia, and LA is almost never used, even in paediatric settings. Additionally, no studies have been conducted locally to support the use of LA for such procedures (Alobayli, 2019). Consequently, patients are often subjected to unnecessary procedural pain, which produces distress and can have negative consequences.…”