Table 2:

Negative Comments by Patients About Urinary Catheters or PICCs (selected)

Topics	Urinary Catheters	PICCs
Patient convenience	None	None
Catheter malfunction	• The patient stated that the catheter sometimes drains slowly and pressure builds up in his bladder and causes him pain. Turns out, the bag wasn’t low enough, so the tube wasn’t draining.   • The patient stated that the leg bag is too small, so it doesn’t hold enough. The catheter is also leaking. The patient stated that he wasn’t given any instruction on how to handle a leak, so he looked up information on the internet. He is having to use adult incontinence products because of the leaking catheter.	• The PICC line flushes okay, but the nurse/doctor is not able to draw blood from the PICC line so the patient is still having to endure blood sticks.   • The PICC line began bleeding spontaneously. No obvious preceding event as participant was sitting watching tv at home.   • Pt stated that his PICC line fell out while he was asleep.
Pain, irritation, discomfort	•It hurt going in and coming out.   • Pt states “It hurt so much.” Wishes he never had the thing in the first place and wishes to never have one again. Would like to know why a catheter was ordered for him since he had no problem urinating in the first place.   • When it was in, it was really uncomfortable.	• Pt stated that the home health nurse used a stronger PICC line bandage which caused his skin to get red and irritated.   • While not really a problem, I do have to stop myself from scratching around it when it gets itchy.   • Patient was allergic to glue on the dressing, so skin was irritated initially and PICC kept coming out a little bit each time the nurses changed the dressing.   • Very uncomfortable to have something sticking out of your arm for over a month   • Bruised and a little swollen where midline was placed   • Area where PICC was placed is numb.   • He has been out of the hospital a few days and his entire arm is swollen and his shoulder is bruised.
Activities of daily living	• Patient found the catheter to be extremely uncomfortable especially while sleeping. Couldn’t turn over well. Felt it was getting caught and tugging which caused discomfort.   • Had trouble with catheter pulling every time I moved and there was nothing I could do about it.   • Made it difficult to start walking after surgery.	• Arm hurts so bad, can’t use left arm, can’t put on a bra   • I can’t get it wet so I have difficulty taking showers. It’s not easy to deal with.   • It’s just annoying that it’s there, I have to be careful when taking showers and doing other activities. It hurts from time to time.
Provider error	• When the nurse placed the second catheter, he did not use gloves. I have a urinary tract infection, and other problems with the catheter.   • The operating room nurse created a false passage when trying to insert the catheter.   • When they removed it, they had a problem getting the balloon to deflate.	• During this last insertion the nurse had a lot of difficulty placing the PICC. A doctor was called to attempt to place it, but they could not successfully insert the PICC.   • The PICC line was removed after X-Ray showed that the tip was in the lower neck.   • Pt stated that the home health nurse coming to his house doesn’t seem to know how to dress the PICC line. The gauze is always rolling up, and they have to come out and re-dress it.   • The only complications I had was when the nurse tried to take the PICC out and was not able to, and I had to go to the emergency room to have them take it out.   • Pt stated that his home health nurse said that the PICC line removal is a little more complicated now. The metal anchors at the end require the line to be removed by someone who is trained in removing this new type of PICC line.   • Pt stated that the doctor didn’t know how to remove the new PICC line catheters. He caused the patient pain, level six, and bruising. The patient stated that her arm hurt for two days, and the doctor had to go find someone who could take out the PICC line.
Other	• Since having the catheter removed, I am getting up every one to two hours at night to urinate. This was not happening prior to the catheter.   • Pt stated that for the first two weeks after the catheter removal, she had issues with her urinary stream stopping and starting. It is back to normal now.   • Pt stated that he noticed his urine had a foul smell one week after the catheter was removed. He has had a urinary tract infection before, and he recognizes the smell.	• The scab where the PICC entered the skin has not healed yet.   • Never want to have another PICC line again.   • If the hospital had better PICC covers or protection, that would be great. If they had better cotton elastic bands to go over the PICC, that would help because the one I have is terrible.   • The ability to keep it covered is a problem. The cover they gave me does not work and I try different things to keep it covered up. It’s really difficult.   • Every time I get my antibiotics I can feel it right in the center of my chest. It stays with me for about 30 minutes after the antibiotic is complete.