Which dressing? Qualitative aspects of a randomised controlled trial of wound dressings

Background/Aims: Many patients are exposed to additional risks because access is via a central venous catheter (CVC). Despite a paucity of evidence, guidelines and policies dictated the use of transparent exit site wound dressings, contrary to local nurses' practice. This study aimed to explore nurses' experiences with three different types of CVC exit site dressings in the context of a randomised controlled trial (RCT). \ud \ud Methods: Seven focus groups were held with haemodialysis nurses across the Renal Service following data collection for the crossover RCT. Four key questions were explored and thematic analysis of the transcripts was undertaken.\ud \ud Results: Fifteen nurses, with varying haemodialysis experience, provided comments on the ease of applying and removing the dressings, problems encountered with the dressings, which dressings types they thought were best or worst, and the value of having a specific work practice instruction developed for the RCT. It was clear that, although no dressing type was perfect, the opaque dressing was the best given the properties of the dressings, the patients' preferences, and the humid climate. \ud \ud Conclusion: These perspectives are congruent with the results from the RCT that the opaque dressing type is safer than the transparent dressing type for these patients. It is suggested that necessary steps are taken to incorporate these local findings in to the health service's policy to reflect current state and national guidelines