BACKGROUND: Peripheral intravenous catheter insertion is a common procedure in emergency departments. Despite clear guidelines, patient experiences vary, and evidence-based practice is inconsistently applied. Understanding patient perspectives is essential to improving care quality. AIM: To explore patient experiences of peripheral intravenous catheter insertion and care in the emergency department, identifying barriers and enablers to evidence-based practice. METHODS: A qualitative study was conducted in an Australian emergency department in 2025. Semi-structured interviews were analysed using thematic analysis, guided by CFIR domains to explore current clinical practice. RESULTS: A total of 13 patients and nine clinicians were interviewed. Patients reported variability in technical skill, communication, and involvement in decision-making. Many felt disempowered by hurried consent processes or convenience-driven insertions, while some preferred that clinicians make decisions. Clinicians identified barriers including limited access to ultrasound, insufficient hands-on training with real patients, workload, time pressures, and a culture discouraging escalation of difficult cannulations. Key enablers included mentorship, role modelling, standardised training, and supportive leadership. Both patients and clinicians emphasised the importance of empathetic communication, tailored information provision, and managing needle-related anxiety. CONCLUSION: Addressing barriers to best clinical practice is critical to improving patient experience and quality outcomes. Future research should explore interventions across diverse hospital settings, including rural and resource-limited emergency departments. Implication for Profession: Enhancing training, structured mentorship, and embedding champions can strengthen clinician capability and confidence. Cultivating a culture of patient-centred care and shared decision-making may improve safety, satisfaction, and adherence to evidence-based practice. REPORTING METHOD: Findings were reported using the Consolidated criteria for reporting qualitative research. PUBLIC CONTRIBUTION: Patients were the sample group.
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