Clinical effects of continuity of nursing care for peripherally inserted central catheters among discharged cancer patients: A systematic review of randomized controlled trials

Abstract

Abstract Background: The duration of peripherally inserted central catheter (PICC) retention can be shortened, and the likelihood of accidental extubation can increase if timely PICC maintenance is not performed after discharge. Furthermore, complications such as PICC blockage, phlebitis, and infection can occur without timely PICC maintenance after discharge. Therefore, providing PICC-catheterized individuals with continuous care after oncologic treatment is crucial. This systematic review and meta-analysis aimed to determine whether continuous care for patients with centrally located catheters can prolong catheter retention, enhance patients’ quality of life, and encourage healthy lifestyle practices. Methods: The PRISMA criteria areguidelines for systematic reviews of relevant peer-reviewed literature. We conducted a randomized controlled trial to evaluate the effects of a continuum of care among patients with cancer. PubMed, the Cochrane Library, and Embase were searched for all relevant studies in English and Chinese until May 31, 2022. Two authors screened the included studies, evaluated eligible studies, and collected relevant data. They resolved any discordant opinions by asking for a senior editor's opinion. The Newcastle-Ottawa Scale tool was used for quality assessment, and the meta-analysis was performed using Review Manager version 5.3. A random-effects model was used when heterogeneitywas >50%. The estimates were expressed using hazard ratios and 95% confidence intervals (CI), and publication bias was assessed using funnel plots. Results: This study included 21 papers (1420 in total were evaluated) in the systematic review. The PICC dwell time was recorded in 10 studies, three focused on quality of life, and six investigated healthy habits. Subgroup and sensitivity analyses were performed for the length of stay (mean difference (MD): 3.43; 95% CI [1.82, 5.04]) and health-promoting lifestyle profile (MD: 24.49; 95% CI [14.92, 34.05]) to reduce heterogeneity. However, these analyses had little impact on total heterogeneity. Conclusions: This study observed that continuous care increased patients' quality of life, altered their manner of life, and extended PICC dwell time.