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Nursing issues
Australian secondary analysis reveals that vascular access device procedures aimed at preventing harm may be causing skin complications
  1. Angie McNamara
  1. Barts Cancer Centre, Barts Health NHS Trust, London, UK
  1. Correspondence to Angie McNamara, Barts Health NHS Trust, London EC1A7BE, UK; Angie.McNamara{at}

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Commentary on: Ullman AJ, Mihala G, O’Leary K, et al. Skin complications associated with vascular access devices: a secondary analysis of 13 studies involving 10,859 devices. Int J Nurs Stud 2019;91:6–13.

Implications for practice and research

  • Clinicians should routinely consider age, medical diagnosis, skin integrity and location of vascular access device before inserting vascular access devices.

  • The use of retrospective studies can adversely impact results due to the limitations in data collected, primarily misclassification bias, the data are subject to confounding and temporal relationships which are often difficult to assess.


There is a wealth of evidence focusing on the prevention of harm when using vascular access devices with the focus being on both reducing systemic and local infections1 and the promotion of device performance.

This study by Ullman and colleagues aims to expand on this knowledge by identifying the patient, device and healthcare-related characteristics associated …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.