Abstract:

Objective To evaluate and summarize the best evidence on the management of primary malposition in adult patients with PICC/arm port，and to provide a reference for clinical staff to identify，prevent and treat primary malposition in adult PICC/arm port. Methods The evidence on management of primary malposition in adult PICC/arm port from international guideline websites，websites of academic societies or institutions，and electronic databases were systematically searched. The retrieved evidence included clinical decision-making，best practice，guidelines，systematic reviews，evidence summaries and expert consensuses. The search time limit was set from inception to December 31st，2023. After that，two researchers evaluated the quality of the literature and extracted the data. Results A total of 13 articles were included in this study，including six clinical practice guidelines，two evidence summaries and five expert consensuses. Finally，39 recommendations were summarized in three aspects of identification，prevention and treatment. Conclusion This study provides an evidence-based basis for clinical staff to manage primary malposition in adult PICC/arm port. It is suggested that clinical staff should fully consider the clinical situation，combine professional judgment and patient wishes，follow the principle of individualization and apply the evidence to clinical practice prudently.

Key words: Central Venous Catheter, Catheterization, Evidence-Based Nursing, Evidence Summary