Construction of an Appropriate Needs Assessment Indicator System for Venous Access Devices in Patients With Septic Shock Based on Fluid Treatment Characteristics: A Delphi Study

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AIM: The objective of this study is to determine a consensus on the evaluation criteria for venous access tools appropriate for each stage of septic shock using the Delphi method. DESIGN: A Delphi design was utilized. METHODS: A preliminary evaluation indicator system was developed through a systematic review of clinical guidelines, evidence summaries, systematic reviews and expert opinions. Using the Delphi method, three rounds of 2-week electronic questionnaires were conducted from June to August 2024 to gather independent expert feedback. The research team included critical care medical and nursing staff, clinical pharmacists and intravenous therapy specialists. Nineteen experts from six tertiary teaching hospitals, all with senior-level titles and over 10 years of clinical experience, participated. The indicator system utilizes a five-point Likert scale method for qualitative feedback. RESULTS: After three rounds expert consultations, a consensus was reached on the needs assessment indicator system, which includes 4 first-level, 11 second-level and 42 third-level. It was tailored to the R.O.S.E. Fluid resuscitation concept model for septic shock at each stage. CONCLUSION: The study constructed an appropriate needs assessment indicator system for venous access devices in patients with septic shock based on fluid treatment needs, which was scientific, reasonable and reliable and provides reference for the clinical practice. IMPLICATIONS FOR THE PROFESSION AND NURSING MANAGEMENT: In this study, a comprehensive assessment indicator system for venous access device requirements was developed, tailored specifically to the fluid therapy needs of septic shock patients across various treatment stages. This system standardizes the alignment of venous access strategies with the dynamic phases of treatment and underscores the significance of catheter de-escalation and timely removal during the tapering and weaning periods. By emphasizing these practices, the system aims to potentially reduce catheter indwelling time, decrease the risk of catheter-related bloodstream infections, enhance patient outcomes and optimize the utilization of medical resources. IMPACT: This study assessed the safety and justification for venous access devices in septic shock patients. Although there is no consensus on the best device planning for critically ill patients, the study established 57 indicators for needs assessment by analyzing fluid therapy requirements at various septic shock stages, achieving expert consensus. These criteria significantly guide clinical practice and impact critical care. REPORTING METHOD: The study is reported informed by 'Guidance on Conducting and REporting DElphi Studies (CREDES) in palliative care: Recommendations derived from a methodological systematic review'. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

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