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Kitada M, Yamamura S, Ninomiya A, Kabashima M, Tateno K, Hori E. Characteristics of Peripheral Intravenous Catheter Cannulation in Older Japanese Inpatients. JOURNAL OF INFUSION NURSING 2025; 48:25-31. [PMID: 39760875 DOI: 10.1097/nan.0000000000000564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2025]
Abstract
Age-related physiological changes affect various aspects of peripheral intravenous catheter (PIVC) cannulation. However, the characteristics of PIVCs, especially in older patients, have been poorly investigated. In the current cross-sectional observational study, PIVC sizes, PIVC sites, the number of attempts until successful insertion, and the degree of venodilation upon insertion among hospital inpatients aged ≥65 years were investigated, along with measurements of the vessel diameter and depth using ultrasound. In total, 91 PIVC insertions were analyzed. The vessel diameter was estimated to be smaller than that in domestic adult inpatients. Most of the catheters were placed at the ideal site on the first attempt. However, considering the optimal vein-to-catheter ratio, most of the cannulations were oversized and would be oversized even when using a 24-gauge catheter. In addition, obvious differences were found in the vessel diameter, catheter size, and catheter site compared with previous studies conducted outside of Asia. The current study indicates the need for further research on the identification of appropriate veins, and the definition of "appropriate" approaches might vary among countries.
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Affiliation(s)
- Motoko Kitada
- Author Affiliations: Faculty of Nursing, Department of Nursing, Josai International University, Chiba, Japan (Mss Kitada and Tateno; Drs Ninomiya and Kabashim); Faculty of Pharmaceutical Sciences, Department of Medical Pharmacy, Josai International University, Chiba, Japan (Dr Yamamura); Behavioral Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan (Dr Hori)
- Motoko Kitada, MHS, RN, PHN, is a professor in the Department of Nursing at Josai International University. She was engaged in infusion nursing at a medical and surgical ward for 7 years, where she encountered and resolved various challenges related to intravenous therapy. Now, her special focus is on education and research with the goal of increasing the safety and quality of infusion therapy. Shigeo Yamamura, PhD, is a professor of the Faculty of Pharmaceutical Sciences at Josai International University. He has been performing research in a variety of fields, including pharmacy, medicine, and education, for more than 40 years. His main research areas involve medical statistics, pharmacy education, and pharmacy practice, but his interests are not limited to these fields. At present, he works with many health care professionals, pharmacists, nurses, medical doctors, and others. Ayako Ninomiya, PhD, RN, PHN, is a professor in the Department of Nursing at Josai International University. She has contributed to various publications on basic nursing skills and has been engaged in the education of both nursing students and newly graduated nurses. Minoru Kabashima, PhD, RN, PHN, is an associate professor in the Department of Nursing at Josai International University. He has a particular interest in difficult intravenous access, vein visualization, and infusion therapy education. Kazuko Tateno, MSN, RN, PHN, is an assistant professor in the Department of Nursing at Josai International University. She is engaged in infusion therapy education and has abundant clinical experience in infusion nursing. Her current research interest is nursing education outcome measurement. Etsuro Hori, PhD, is a professor of Behavioral Sciences at the Graduate School of Medicine and Pharmaceutical Sciences at the University of Toyama. He specializes in a variety of fields in the physiological sciences and has published extensively, particularly in the field of neuroscience
| | - Shigeo Yamamura
- Author Affiliations: Faculty of Nursing, Department of Nursing, Josai International University, Chiba, Japan (Mss Kitada and Tateno; Drs Ninomiya and Kabashim); Faculty of Pharmaceutical Sciences, Department of Medical Pharmacy, Josai International University, Chiba, Japan (Dr Yamamura); Behavioral Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan (Dr Hori)
- Motoko Kitada, MHS, RN, PHN, is a professor in the Department of Nursing at Josai International University. She was engaged in infusion nursing at a medical and surgical ward for 7 years, where she encountered and resolved various challenges related to intravenous therapy. Now, her special focus is on education and research with the goal of increasing the safety and quality of infusion therapy. Shigeo Yamamura, PhD, is a professor of the Faculty of Pharmaceutical Sciences at Josai International University. He has been performing research in a variety of fields, including pharmacy, medicine, and education, for more than 40 years. His main research areas involve medical statistics, pharmacy education, and pharmacy practice, but his interests are not limited to these fields. At present, he works with many health care professionals, pharmacists, nurses, medical doctors, and others. Ayako Ninomiya, PhD, RN, PHN, is a professor in the Department of Nursing at Josai International University. She has contributed to various publications on basic nursing skills and has been engaged in the education of both nursing students and newly graduated nurses. Minoru Kabashima, PhD, RN, PHN, is an associate professor in the Department of Nursing at Josai International University. He has a particular interest in difficult intravenous access, vein visualization, and infusion therapy education. Kazuko Tateno, MSN, RN, PHN, is an assistant professor in the Department of Nursing at Josai International University. She is engaged in infusion therapy education and has abundant clinical experience in infusion nursing. Her current research interest is nursing education outcome measurement. Etsuro Hori, PhD, is a professor of Behavioral Sciences at the Graduate School of Medicine and Pharmaceutical Sciences at the University of Toyama. He specializes in a variety of fields in the physiological sciences and has published extensively, particularly in the field of neuroscience
| | - Ayako Ninomiya
- Author Affiliations: Faculty of Nursing, Department of Nursing, Josai International University, Chiba, Japan (Mss Kitada and Tateno; Drs Ninomiya and Kabashim); Faculty of Pharmaceutical Sciences, Department of Medical Pharmacy, Josai International University, Chiba, Japan (Dr Yamamura); Behavioral Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan (Dr Hori)
- Motoko Kitada, MHS, RN, PHN, is a professor in the Department of Nursing at Josai International University. She was engaged in infusion nursing at a medical and surgical ward for 7 years, where she encountered and resolved various challenges related to intravenous therapy. Now, her special focus is on education and research with the goal of increasing the safety and quality of infusion therapy. Shigeo Yamamura, PhD, is a professor of the Faculty of Pharmaceutical Sciences at Josai International University. He has been performing research in a variety of fields, including pharmacy, medicine, and education, for more than 40 years. His main research areas involve medical statistics, pharmacy education, and pharmacy practice, but his interests are not limited to these fields. At present, he works with many health care professionals, pharmacists, nurses, medical doctors, and others. Ayako Ninomiya, PhD, RN, PHN, is a professor in the Department of Nursing at Josai International University. She has contributed to various publications on basic nursing skills and has been engaged in the education of both nursing students and newly graduated nurses. Minoru Kabashima, PhD, RN, PHN, is an associate professor in the Department of Nursing at Josai International University. He has a particular interest in difficult intravenous access, vein visualization, and infusion therapy education. Kazuko Tateno, MSN, RN, PHN, is an assistant professor in the Department of Nursing at Josai International University. She is engaged in infusion therapy education and has abundant clinical experience in infusion nursing. Her current research interest is nursing education outcome measurement. Etsuro Hori, PhD, is a professor of Behavioral Sciences at the Graduate School of Medicine and Pharmaceutical Sciences at the University of Toyama. He specializes in a variety of fields in the physiological sciences and has published extensively, particularly in the field of neuroscience
| | - Minoru Kabashima
- Author Affiliations: Faculty of Nursing, Department of Nursing, Josai International University, Chiba, Japan (Mss Kitada and Tateno; Drs Ninomiya and Kabashim); Faculty of Pharmaceutical Sciences, Department of Medical Pharmacy, Josai International University, Chiba, Japan (Dr Yamamura); Behavioral Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan (Dr Hori)
- Motoko Kitada, MHS, RN, PHN, is a professor in the Department of Nursing at Josai International University. She was engaged in infusion nursing at a medical and surgical ward for 7 years, where she encountered and resolved various challenges related to intravenous therapy. Now, her special focus is on education and research with the goal of increasing the safety and quality of infusion therapy. Shigeo Yamamura, PhD, is a professor of the Faculty of Pharmaceutical Sciences at Josai International University. He has been performing research in a variety of fields, including pharmacy, medicine, and education, for more than 40 years. His main research areas involve medical statistics, pharmacy education, and pharmacy practice, but his interests are not limited to these fields. At present, he works with many health care professionals, pharmacists, nurses, medical doctors, and others. Ayako Ninomiya, PhD, RN, PHN, is a professor in the Department of Nursing at Josai International University. She has contributed to various publications on basic nursing skills and has been engaged in the education of both nursing students and newly graduated nurses. Minoru Kabashima, PhD, RN, PHN, is an associate professor in the Department of Nursing at Josai International University. He has a particular interest in difficult intravenous access, vein visualization, and infusion therapy education. Kazuko Tateno, MSN, RN, PHN, is an assistant professor in the Department of Nursing at Josai International University. She is engaged in infusion therapy education and has abundant clinical experience in infusion nursing. Her current research interest is nursing education outcome measurement. Etsuro Hori, PhD, is a professor of Behavioral Sciences at the Graduate School of Medicine and Pharmaceutical Sciences at the University of Toyama. He specializes in a variety of fields in the physiological sciences and has published extensively, particularly in the field of neuroscience
| | - Kazuko Tateno
- Author Affiliations: Faculty of Nursing, Department of Nursing, Josai International University, Chiba, Japan (Mss Kitada and Tateno; Drs Ninomiya and Kabashim); Faculty of Pharmaceutical Sciences, Department of Medical Pharmacy, Josai International University, Chiba, Japan (Dr Yamamura); Behavioral Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan (Dr Hori)
- Motoko Kitada, MHS, RN, PHN, is a professor in the Department of Nursing at Josai International University. She was engaged in infusion nursing at a medical and surgical ward for 7 years, where she encountered and resolved various challenges related to intravenous therapy. Now, her special focus is on education and research with the goal of increasing the safety and quality of infusion therapy. Shigeo Yamamura, PhD, is a professor of the Faculty of Pharmaceutical Sciences at Josai International University. He has been performing research in a variety of fields, including pharmacy, medicine, and education, for more than 40 years. His main research areas involve medical statistics, pharmacy education, and pharmacy practice, but his interests are not limited to these fields. At present, he works with many health care professionals, pharmacists, nurses, medical doctors, and others. Ayako Ninomiya, PhD, RN, PHN, is a professor in the Department of Nursing at Josai International University. She has contributed to various publications on basic nursing skills and has been engaged in the education of both nursing students and newly graduated nurses. Minoru Kabashima, PhD, RN, PHN, is an associate professor in the Department of Nursing at Josai International University. He has a particular interest in difficult intravenous access, vein visualization, and infusion therapy education. Kazuko Tateno, MSN, RN, PHN, is an assistant professor in the Department of Nursing at Josai International University. She is engaged in infusion therapy education and has abundant clinical experience in infusion nursing. Her current research interest is nursing education outcome measurement. Etsuro Hori, PhD, is a professor of Behavioral Sciences at the Graduate School of Medicine and Pharmaceutical Sciences at the University of Toyama. He specializes in a variety of fields in the physiological sciences and has published extensively, particularly in the field of neuroscience
| | - Etsuro Hori
- Author Affiliations: Faculty of Nursing, Department of Nursing, Josai International University, Chiba, Japan (Mss Kitada and Tateno; Drs Ninomiya and Kabashim); Faculty of Pharmaceutical Sciences, Department of Medical Pharmacy, Josai International University, Chiba, Japan (Dr Yamamura); Behavioral Science, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan (Dr Hori)
- Motoko Kitada, MHS, RN, PHN, is a professor in the Department of Nursing at Josai International University. She was engaged in infusion nursing at a medical and surgical ward for 7 years, where she encountered and resolved various challenges related to intravenous therapy. Now, her special focus is on education and research with the goal of increasing the safety and quality of infusion therapy. Shigeo Yamamura, PhD, is a professor of the Faculty of Pharmaceutical Sciences at Josai International University. He has been performing research in a variety of fields, including pharmacy, medicine, and education, for more than 40 years. His main research areas involve medical statistics, pharmacy education, and pharmacy practice, but his interests are not limited to these fields. At present, he works with many health care professionals, pharmacists, nurses, medical doctors, and others. Ayako Ninomiya, PhD, RN, PHN, is a professor in the Department of Nursing at Josai International University. She has contributed to various publications on basic nursing skills and has been engaged in the education of both nursing students and newly graduated nurses. Minoru Kabashima, PhD, RN, PHN, is an associate professor in the Department of Nursing at Josai International University. He has a particular interest in difficult intravenous access, vein visualization, and infusion therapy education. Kazuko Tateno, MSN, RN, PHN, is an assistant professor in the Department of Nursing at Josai International University. She is engaged in infusion therapy education and has abundant clinical experience in infusion nursing. Her current research interest is nursing education outcome measurement. Etsuro Hori, PhD, is a professor of Behavioral Sciences at the Graduate School of Medicine and Pharmaceutical Sciences at the University of Toyama. He specializes in a variety of fields in the physiological sciences and has published extensively, particularly in the field of neuroscience
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Ní Chróinín D, Ray-Barruel G, Carr PJ, Frost SA, Rickard CM, Mifflin N, McManus C, Alexandrou E. The burden of peripheral intravenous catheters in older hospital inpatients: A national cross-sectional study part of the ONE MILLION GLOBAL PERIPHERAL INTRAVENOUS CATHETERS COLLABORATION. Australas J Ageing 2022; 42:98-107. [PMID: 35384222 DOI: 10.1111/ajag.13068] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 02/10/2022] [Accepted: 02/13/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To investigate the burden of peripheral intravenous catheters (PIVCs) in older hospitalised patients. METHODS A cross-sectional prospective observational study (2014/2015) to describe the characteristics, indications and outcomes of PIVCs among patients aged ≥65 from 65 Australian hospitals. RESULTS Amongst 2179 individual PIVCs (in 2041 patients, mean age 77.6 years, 45% female, 58% in NSW), 43% were inserted by doctors and 74% used that day, meaning 25% were 'idle'. Overall, 18% (393/2179) exhibited signs of PIVC-related complications. Most commonly exhibited PIVC-related complications were tenderness (4.1%) and local redness (1.8%). Nearly one in three (29.1%) dressings was soiled, loosened or had come off, and only 36.8% had the time and date documented on the dressing. Both infusing IV medications (aOR 1.74, 95% CI 1.28-2.38, p < 0.001) and inserting the PIVC in a non-upper limb vein (aOR 3.40 compared to forearm [reference site], 95% CI 1.62-7.17, p < 0.001) were independently associated with PIVC failure. Phlebitis was exhibited in 7% (154) of the patients. Only infusing intravenous medications increased the likelihood of developing symptoms of phlebitis (aOR 1.61, 95% CI 1.01-2.57, p = 0.05). Increasing age was inversely associated with symptoms of phlebitis. Among the 1575 patients (79%) who rated their PIVC experience using the Likert scale 0-10 (where 10 = 'best possible'), the median score was 8 (IQR 6-10). Age in highest quartile (>84 years) was independently associated with lower likelihood of a high score (aOR 0.71, 95% CI 0.54-0.94, p = 0.02). CONCLUSIONS Given 1 in 5 PIVCs were identified with having complications, further research should focus on optimising PIVC use in older patients.
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Affiliation(s)
- Danielle Ní Chróinín
- Liverpool Hospital, Liverpool, New South Wales, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Gillian Ray-Barruel
- Alliance for Vascular Access Teaching and Research (AVATAR) Group, Menzies Health Institute, Griffith University, Brisbane, Queensland, Australia.,School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
| | - Peter J Carr
- Alliance for Vascular Access Teaching and Research (AVATAR) Group, Menzies Health Institute, Griffith University, Brisbane, Queensland, Australia.,School of Nursing and Midwifery, National University of Ireland, Galway, Ireland
| | - Steven A Frost
- Liverpool Hospital, Liverpool, New South Wales, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia.,Centre for Applied Nursing Research, School of Nursing and Midwifery, Western Sydney University and Ingham Institute of Applied Medical Research, Liverpool, New South Wales, Australia
| | - Claire M Rickard
- Alliance for Vascular Access Teaching and Research (AVATAR) Group, Menzies Health Institute, Griffith University, Brisbane, Queensland, Australia.,Metro North Hospitals and Health Service, School of Nursing, Midwifery and Social Work, University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia
| | | | - Craig McManus
- Liverpool Hospital, Liverpool, New South Wales, Australia
| | - Evan Alexandrou
- Liverpool Hospital, Liverpool, New South Wales, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia.,Alliance for Vascular Access Teaching and Research (AVATAR) Group, Menzies Health Institute, Griffith University, Brisbane, Queensland, Australia.,Centre for Applied Nursing Research, School of Nursing and Midwifery, Western Sydney University and Ingham Institute of Applied Medical Research, Liverpool, New South Wales, Australia
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