Beyond Routine: How Nurses Make PICC Dressing and Securement Decisions

Posted on 21 July 2026

Study Overview

PICC dressing and securement care may appear routine, but nurses make a series of complex decisions each time a dressing is applied or removed. This qualitative study explored how nurses working in adult and paediatric cancer care think through these decisions.

Fourteen registered nurses from two Brisbane cancer care wards participated in “Think Aloud” sessions while applying and removing different dressing and securement combinations. Their decision-making was examined through the lens of intuitive and analytical thinking.

Key Findings

Experience and ward culture shape routine practice
- Many decisions were made intuitively, drawing on familiar products, established habits, and the way care was commonly delivered within the ward.
Product familiarity influences confidence
- Nurses were more comfortable using products they knew well. Unfamiliar dressing and securement combinations required more deliberate thought and could affect how confidently they were applied.
Patient needs prompted deeper reasoning
- Analytical decision-making became more visible when nurses considered factors such as skin integrity, previous complications, patient comfort, and individual preferences.
Planning started before the dressing change
- Nurses assessed the patient, available products, ward resources, and possible challenges before beginning the procedure.
Education was valued, but practice was not always consistent
- Participants recognised the importance of evidence-based care, although personal experience, local rituals, and product availability sometimes had greater influence on practice.

Implications

PICC dressing and securement decisions involve more than following a standard procedure. Nurses combine clinical knowledge, experience, patient assessment, and familiarity with available products to guide care.

The findings support targeted education that explains not only how to use dressing and securement products, but why different options may be appropriate. Structured reflection, consistent guidance, and supportive ward cultures may help nurses move beyond habit and apply evidence-based, patient-specific decisions more consistently.

Read more: https://doi.org/10.1016/j.soncn.2026.152259https://doi.org/10.1016/j.soncn.2026.152259

Authors: Emily N. Larsen; Jane Wickins; Nicole Marsh; India Pearse; Victoria Gibson; Amanda J. Ullman; Alexandra L. McCarthy; Catherine O’Brien; Claire M. Rickard; Samantha Keogh

Beyond Routine: How Nurses Make PICC Dressing and Securement Decisions

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