What Shapes Nurses’ Decisions During PICC Dressing and Securement Care?

Study Overview
PICC dressing and securement care may appear routine, but nurses make multiple decisions during application and removal that can influence device safety and patient comfort.

This qualitative study explored how nurses working in adult and paediatric cancer care make these decisions. Fourteen registered nurses participated in “Think Aloud” sessions while applying and removing different dressing and securement combinations, allowing researchers to examine both intuitive and analytical decision-making.

Key Findings

• Five interconnected themes shaped nurses’ decision-making: education and value, rituals and culture, product familiarity, anticipatory assessment and planning, and thoughtful practice.
• Routine decisions were often intuitive and influenced by familiar products and established ward practices.
• More deliberate decision-making occurred when nurses considered individual patient factors, including skin integrity and patient preferences.
• Nurses also planned ahead by considering the patient, available products and ward resources before choosing how to dress and secure the PICC.

Implications
PICC dressing and securement involves more clinical reasoning than simply following a standard procedure.
Targeted education, opportunities for reflective practice and a ward culture that supports evidence-based decision-making may help nurses move beyond routine habits and tailor care to individual patient needs.

Read more:https://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