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Haskey E, Maund V, Allerton F, Browse B, Heard C, O'Donnell C, Davison K, Hertel C, Booth E, Lawrence S, Dever E, Bowe L, Taylor H, Hall K, Trimble K, Junior M, Fennell C, Stevenson N, Sterritt A, Penn E, Nowell L, Collins A, Jones E, Scudder C. Placement, management and complications associated with peripheral intravenous catheter use in UK small animal practice. J Small Anim Pract 2024. [PMID: 39238283 DOI: 10.1111/jsap.13782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 07/01/2024] [Accepted: 08/07/2024] [Indexed: 09/07/2024]
Abstract
OBJECTIVES To describe the techniques for preparation and placement of peripheral intravenous catheters (PIVCs), to describe the complications associated with PIVCs, and to identify factors associated with PIVC complications in small animal practice in the United Kingdom. MATERIALS AND METHODS A prospective multicentre observational study was undertaken between January 2022 and January 2023. Data collected included patient information, information regarding the placement and maintenance of PIVCs, and PIVC complications, from privately owned cats and dogs presenting to veterinary institutes in the United Kingdom. Patients required a PIVC to be placed as part of their care and the PIVC was anticipated to be in situ for >24 hours to be eligible for PIVC complication analysis. RESULTS A total of 19 institutes recorded data regarding 382 PIVCs, with 325 (85.1%) placed in dogs and 57 (14.9%) in cats. The most common reasons for placement were to administer intravenous fluid therapy (74.3%) and intravenous medications (71.7%). There were 102 of 382 (26.7%) PIVCs associated with a complication, with limb swelling/suspected phlebitis in 44 of 382 (11.5%) and PIVC dislodgement/patient interference in 30 of 382 (7.9%) PIVCs. Factors associated with increased risk of complication were more than 1 attempt to place the PIVC, a second or subsequent PIVC being placed during hospitalisation, flush frequency different than every 1 to 24 hours, and flush solution with compound sodium lactate. CLINICAL SIGNIFICANCE Veterinary professionals must be vigilant when monitoring a patient with a PIVC in situ, particularly if a PIVC is associated with one of the aforementioned factors of increased likelihood of complication.
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Affiliation(s)
- E Haskey
- Clinical Sciences and Services, Royal Veterinary College, Potters Bar, UK
| | - V Maund
- Willows Veterinary Centre and Referral Service, Solihull, UK
| | - F Allerton
- Willows Veterinary Centre and Referral Service, Solihull, UK
| | - B Browse
- Cave Veterinary Specialists, Wellington, UK
| | - C Heard
- Highcroft Veterinary Specialists, Bristol, UK
| | | | - K Davison
- Paragon Veterinary Referrals, Wakefield, UK
| | - C Hertel
- Quarry Veterinary Group, Shrewsbury, UK
| | - E Booth
- Quarry Veterinary Group, Shrewsbury, UK
| | - S Lawrence
- Davies Veterinary Specialists, Hertfordshire, UK
| | - E Dever
- Kentdale Referrals, Milnthorpe, UK
| | - L Bowe
- Kentdale Referrals, Milnthorpe, UK
| | - H Taylor
- Dick White Referrals, Cambridgeshire, UK
| | - K Hall
- Dick White Referrals, Cambridgeshire, UK
| | - K Trimble
- Wear Referrals Veterinary Specialist & Emergency Hospital, Stockton-on-Tees, UK
| | - M Junior
- Wear Referrals Veterinary Specialist & Emergency Hospital, Stockton-on-Tees, UK
| | - C Fennell
- Southfields Veterinary Specialists, Essex, UK
| | | | - A Sterritt
- Taverham Veterinary Hospital, Norwich, UK
| | - E Penn
- Willows Veterinary Group, Cheshire, UK
| | | | | | - E Jones
- North Wales Veterinary Referrals, Buckley, UK
| | - C Scudder
- Clinical Sciences and Services, Royal Veterinary College, Potters Bar, UK
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Meto E, Cabout E, Rosay H, Espinasse F, Lot AS, Hajjam ME, Gnamien Clermont S, Launois R. Cost comparison of four venous catheters: Short peripheral catheter, Long peripheral line, Midline, and PICC for peripheral infusion. J Vasc Access 2024:11297298241258257. [PMID: 38855974 DOI: 10.1177/11297298241258257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024] Open
Abstract
INTRODUCTION The use of midline catheters for patients requiring a peripheral IV infusion is sometimes limited by their cost. Although decision trees allow them to be positioned in relation to short peripheral cannulas (SPC), Midlines, and PICCs, their economic impact has not yet been evaluated. A study was conducted to estimate and compare the actual costs of using the three types of catheters for durations of 7, 14, and 21 days. METHODS A budget impact analysis compared midlines or mini-midlines/long peripheral cannulas (LPCs) with SPCs and PICCs for typical medical indications excluding indications requiring central line (infusion of irritant or vesicant drugs): treatment of peritonitis over 7 days, cystic fibrosis infection over 14 days, and meningitis over 21 days. A micro-costing study identified resources used during catheter care procedures (consumables, medical/nursing care, examinations, mechanical complications). The cost of remote systemic complications was estimated from the French national cost study. Literature review compared data based on published complication frequencies. RESULTS Midline is more economic than the SPC (saving of 39€ over 7 days and 174€ over 14 days), and than the PICC (saving of 102€ over 14 days and 95€ over 21 days). DISCUSSION Despite a much higher acquisition cost of the Midline than a SPC, the cost of using a Midline is lower. Although this approach cannot be the only argument for choosing a medical device, it can contribute to it in a tense economic context. The micro-costing has been performed in a center placing PICCline using fluoroscopy for catheter tip positioning. The implantation of a PICC with ECG technique does not require an interventional radiology facility and involves significantly lower logistical and personnel costs. This factor is a limitation in this study. However, even with the use of EGC, the cost difference is in favor of Midline.
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Affiliation(s)
- Elise Meto
- Réseau d'Evaluation en Economie de la Santé (REES France), Paris, France
| | - Elise Cabout
- Réseau d'Evaluation en Economie de la Santé (REES France), Paris, France
| | - Hervé Rosay
- Centre Léon Bérard, Centre de lutte contre le cancer, Lyon, France
| | | | | | | | | | - Robert Launois
- Réseau d'Evaluation en Economie de la Santé (REES France), Paris, France
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Godfrey J, Gallipoli L. Introducing an ultrasound-guided longer length peripheral IV catheter for patients with difficult venous access. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2024; 33:S4-S8. [PMID: 38700139 DOI: 10.12968/bjon.2024.33.7.s4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2024]
Abstract
AIM Insertion of a peripheral intravenous catheter (PIVC) is one of the most common procedures carried out in hospitals worldwide, but failure rates are unacceptably high. This local quality improvement project aimed to assess improvements in first-stick success rate, dwell time and overall catheter success rate when implementing a longer-length peripheral intravenous catheter (LPIVC) under ultrasound guidance for patients with difficult venous access (DVA). METHODS Data were collected from 386 DVA patients requiring a PIVC at one hospital. Number of catheter insertion attempts, catheter dwell time and reason for catheter removal were recorded for each patient. To implement the new DVA catheterisation pathway, registered nurses undertook a training programme comprising workshops and ultrasound-guided cannulation technique practice on phantoms. Costs and waste weights associated with LPIVC insertion, compared with midline insertion, were calculated. RESULTS First-stick success rate was 95.0% using the LPIVC under ultrasound guidance. Dwell time ranged from 1 to 80 days, with a large proportion of those dwelling <1 day being placed in day-case patients. Treatment success rate with the LPIVCs was 83.6%. Equipment costs for an LPIVC insertion were £89.22 lower than for a midline insertion, and the weight of waste generated per procedure was 1 kg lower for LPIVCs. CONCLUSIONS First-stick success rate of LPIVCs, aided by improved purchase in the vein and visualisation with ultrasound guidance, was very high, superior to rates reported in other studies. The procedure provides a better patient experience as successful first attempts avoid unnecessary further insertion attempts. Other benefits are increased nursing time efficiency, a reduction in clinical waste and the lower cost of the equipment required.
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Affiliation(s)
- Julie Godfrey
- Lead Vascular Access Consultant Nurse, Mid and South Essex NHS Foundation Trust
| | - Luigi Gallipoli
- PICC and Vascular Access Clinical Nurse Specialist, Mid and South Essex NHS Foundation Trust
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Álvarez-Morales L, Gómez-Urquiza JL, Suleiman-Martos N, Membrive-Jiménez MJ, González-Díaz A, García Pérez R, Liñán-Gonzalez A. Ultrasound-guided peripheral intravenous canulation by emergency nurses: A systematic review and meta-analysis. Int Emerg Nurs 2024; 73:101422. [PMID: 38401479 DOI: 10.1016/j.ienj.2024.101422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 01/05/2024] [Accepted: 02/01/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Peripheral intravenous cannulation is a common procedure in the emergency department. Nevertheless, failure rates during the first attempt are as high as 40% in adults and 65% in children. Evidence suggests that physician performed ultrasound-guided peripheral intravenous cannulation (USG-PIVC) is an effective alternative to the traditional method; however, there is insufficient data on the efficacy of the technique performed by nurses. OBJECTIVE To examine the efficacy of the USG-PIVC technique performed by emergency department nurses. METHODS A literature review with meta-analysis was performed. The databases used were PubMed, Scopus and CINAHL. The search was conducted in March 2023. Two meta-analysis one of clinical trials about the effectiveness and one about the succession rate were performed. RESULTS 20 studies were selected and analysed. The studies showed that USGPIVC performed by emergency nurses increased the probability of both the overall success and a successful first attempt compared to the standard technique. In addition, patients showed high satisfaction and lower complication rates. However, the procedure had no significant effect on the time or number of attempts required. A lower probability of success was obtained as regards peripheral intravenous cannulation when the standard technique was used, OR = 0.42 (95 %CI 0.25-0.70p < 0,05). CONCLUSIONS Ultrasound-guided peripheral intravenous cannulation performed by emergency nurses is a safe and effective technique.
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Affiliation(s)
- Lorena Álvarez-Morales
- Faculty of Health Sciences, University of Granada, 18016, Conocimiento Avenue, Granada, Spain
| | - José L Gómez-Urquiza
- Ceuta Faculty of Health Sciences, University of Granada, Cortadura del Valle s/n, 51001 Ceuta, Spain.
| | - Nora Suleiman-Martos
- Faculty of Health Sciences, University of Granada, 18016, Conocimiento Avenue, Granada, Spain
| | | | - Ana González-Díaz
- Ceuta Faculty of Health Sciences, University of Granada, Cortadura del Valle s/n, 51001 Ceuta, Spain
| | - Raquel García Pérez
- Faculty of Health Sciences, University of Granada, 18016, Conocimiento Avenue, Granada, Spain
| | - Antonio Liñán-Gonzalez
- Melilla Faculty of Health Sciences, University of Granada, Santader St., 52005 Melilla, Spain
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Bahl A, Alsbrooks K, Zazyczny KA, Johnson S, Hoerauf K. An Improved Definition and SAFE Rule for Predicting Difficult Intravascular Access (DIVA) in Hospitalized Adults. JOURNAL OF INFUSION NURSING 2024; 47:96-107. [PMID: 38377305 PMCID: PMC10913859 DOI: 10.1097/nan.0000000000000535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Patients with difficult intravascular access (DIVA) are common, yet the condition is often ignored or poorly managed, leading to patient dissatisfaction and misuse of health care resources. This study sought to assess all published risk factors associated with DIVA in order to promote prospective identification and improved management of patients with DIVA. A systematic literature review on risk factors associated with DIVA was conducted. Risk factors published in ≥4 eligible studies underwent a multivariate meta-analysis of multiple factors (MVMA-MF) using the Bayesian framework. Of 2535 unique publications identified, 20 studies were eligible for review. In total, 82 unique DIVA risk factors were identified, with the 10 factors found in ≥4 studies undergoing MVMA-MF. Significant predictors of DIVA included vein visibility, vein palpability, history of DIVA, obesity (body mass index [BMI] >30), and history of intravenous (IV) drug abuse, which were combined to create the mnemonic guideline, SAFE: See, Ask (about a history of DIVA or IV drug abuse), Feel, and Evaluate BMI. By recognizing patients with DIVA before the first insertion attempt and treating them from the outset with advanced vein visualization techniques, patients with DIVA could be subject to less frequent painful venipunctures, fewer delays in treatment, and a reduction in other DIVA-associated burdens.
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Affiliation(s)
- Amit Bahl
- Emergency Medicine, Beaumont Hospital, Royal Oak, Michigan (Bahl and Johnson), Becton Dickinson and Co, Franklin Lakes, New Jersey (Alsbrooks and Hoerauf), and Bryn Mawr Hospital, Bryn Mawr, Pennsylvania (Zazyczny)
- Amit Bahl, MD, is a physician scientist with board certification in emergency medicine and subspeciality expertise in point-of-care ultrasound. He is the recipient of several foundation and industry grants for research and has authored numerous peer-reviewed manuscripts in high-impact medical journals. Dr Bahl is a passionate speaker who presents internationally on the complications of vascular access devices and strategies to improve patient outcomes
- Kim Alsbrooks has over 30 years of experience in the medical field. She started as a Radiologic Technologist then Registered Nurse, working on specialized hospital teams in Oncology and Vascular Access. She has worked at BARD/Becton, Dickinson, and Company, where she is now the Sr Director of Medical Affairs, for the past 20 years. Her work is mostly focused on vascular access evidence generation and research. Kim speaks across the US and internationally on vascular access topics
- Kelly Ann Zazyczny, BSN, RN, RT (R), VA-BC, is the director of nursing of the Psychiatric, Women, and Children's Division at Bryn Mawr Hospital, Vascular Access Nursing Services for the Main Line Health System. She has been a clinical leader for over 25 years, holding positions at Main Line Health, The Children's Hospital of Philadelphia, and Children's Healthcare of Atlanta. Her clinical focus has been on pediatrics, vascular access, radiology, and research. She has been named one of the Top Nurses in Nursing Management by Main Line Today for the last 3 years
- Steven Johnson, DO, is a board-certified emergency medicine physician and critical care fellow at the University of Southern California. He also conducts catheter-related research in his work as a research scientist at Beaumont Health. He developed a passion for improving peripheral venous access after witnessing firsthand how poor catheter performance affects patient outcomes and overall health
- Klaus Hoerauf, MD, PhD, currently serves as worldwide vice president of medical affairs, medication delivery solutions, at Becton, Dickinson, and Company. In this role, he leads Medical & Scientific Affairs and Health Economics and Outcomes Research departments. He has an MD and a Doctorate in Cardiology from the Medical University of Münster and has been appointed as associate professor of anesthesiology and intensive care medicine at the Medical University of Vienna, Austria. He is certified in anesthesiology and intensive care medicine, emergency medicine, and pain therapy
| | - Kimberly Alsbrooks
- Corresponding Author: Kimberly Alsbrooks, BSN, RN, RT (R), VA-BC, Becton Dickinson and Company, 18-03 NJ-208, Franklin Lakes, NJ, USA 07417 ()
| | - Kelly Ann Zazyczny
- Emergency Medicine, Beaumont Hospital, Royal Oak, Michigan (Bahl and Johnson), Becton Dickinson and Co, Franklin Lakes, New Jersey (Alsbrooks and Hoerauf), and Bryn Mawr Hospital, Bryn Mawr, Pennsylvania (Zazyczny)
- Amit Bahl, MD, is a physician scientist with board certification in emergency medicine and subspeciality expertise in point-of-care ultrasound. He is the recipient of several foundation and industry grants for research and has authored numerous peer-reviewed manuscripts in high-impact medical journals. Dr Bahl is a passionate speaker who presents internationally on the complications of vascular access devices and strategies to improve patient outcomes
- Kim Alsbrooks has over 30 years of experience in the medical field. She started as a Radiologic Technologist then Registered Nurse, working on specialized hospital teams in Oncology and Vascular Access. She has worked at BARD/Becton, Dickinson, and Company, where she is now the Sr Director of Medical Affairs, for the past 20 years. Her work is mostly focused on vascular access evidence generation and research. Kim speaks across the US and internationally on vascular access topics
- Kelly Ann Zazyczny, BSN, RN, RT (R), VA-BC, is the director of nursing of the Psychiatric, Women, and Children's Division at Bryn Mawr Hospital, Vascular Access Nursing Services for the Main Line Health System. She has been a clinical leader for over 25 years, holding positions at Main Line Health, The Children's Hospital of Philadelphia, and Children's Healthcare of Atlanta. Her clinical focus has been on pediatrics, vascular access, radiology, and research. She has been named one of the Top Nurses in Nursing Management by Main Line Today for the last 3 years
- Steven Johnson, DO, is a board-certified emergency medicine physician and critical care fellow at the University of Southern California. He also conducts catheter-related research in his work as a research scientist at Beaumont Health. He developed a passion for improving peripheral venous access after witnessing firsthand how poor catheter performance affects patient outcomes and overall health
- Klaus Hoerauf, MD, PhD, currently serves as worldwide vice president of medical affairs, medication delivery solutions, at Becton, Dickinson, and Company. In this role, he leads Medical & Scientific Affairs and Health Economics and Outcomes Research departments. He has an MD and a Doctorate in Cardiology from the Medical University of Münster and has been appointed as associate professor of anesthesiology and intensive care medicine at the Medical University of Vienna, Austria. He is certified in anesthesiology and intensive care medicine, emergency medicine, and pain therapy
| | - Steven Johnson
- Emergency Medicine, Beaumont Hospital, Royal Oak, Michigan (Bahl and Johnson), Becton Dickinson and Co, Franklin Lakes, New Jersey (Alsbrooks and Hoerauf), and Bryn Mawr Hospital, Bryn Mawr, Pennsylvania (Zazyczny)
- Amit Bahl, MD, is a physician scientist with board certification in emergency medicine and subspeciality expertise in point-of-care ultrasound. He is the recipient of several foundation and industry grants for research and has authored numerous peer-reviewed manuscripts in high-impact medical journals. Dr Bahl is a passionate speaker who presents internationally on the complications of vascular access devices and strategies to improve patient outcomes
- Kim Alsbrooks has over 30 years of experience in the medical field. She started as a Radiologic Technologist then Registered Nurse, working on specialized hospital teams in Oncology and Vascular Access. She has worked at BARD/Becton, Dickinson, and Company, where she is now the Sr Director of Medical Affairs, for the past 20 years. Her work is mostly focused on vascular access evidence generation and research. Kim speaks across the US and internationally on vascular access topics
- Kelly Ann Zazyczny, BSN, RN, RT (R), VA-BC, is the director of nursing of the Psychiatric, Women, and Children's Division at Bryn Mawr Hospital, Vascular Access Nursing Services for the Main Line Health System. She has been a clinical leader for over 25 years, holding positions at Main Line Health, The Children's Hospital of Philadelphia, and Children's Healthcare of Atlanta. Her clinical focus has been on pediatrics, vascular access, radiology, and research. She has been named one of the Top Nurses in Nursing Management by Main Line Today for the last 3 years
- Steven Johnson, DO, is a board-certified emergency medicine physician and critical care fellow at the University of Southern California. He also conducts catheter-related research in his work as a research scientist at Beaumont Health. He developed a passion for improving peripheral venous access after witnessing firsthand how poor catheter performance affects patient outcomes and overall health
- Klaus Hoerauf, MD, PhD, currently serves as worldwide vice president of medical affairs, medication delivery solutions, at Becton, Dickinson, and Company. In this role, he leads Medical & Scientific Affairs and Health Economics and Outcomes Research departments. He has an MD and a Doctorate in Cardiology from the Medical University of Münster and has been appointed as associate professor of anesthesiology and intensive care medicine at the Medical University of Vienna, Austria. He is certified in anesthesiology and intensive care medicine, emergency medicine, and pain therapy
| | - Klaus Hoerauf
- Emergency Medicine, Beaumont Hospital, Royal Oak, Michigan (Bahl and Johnson), Becton Dickinson and Co, Franklin Lakes, New Jersey (Alsbrooks and Hoerauf), and Bryn Mawr Hospital, Bryn Mawr, Pennsylvania (Zazyczny)
- Amit Bahl, MD, is a physician scientist with board certification in emergency medicine and subspeciality expertise in point-of-care ultrasound. He is the recipient of several foundation and industry grants for research and has authored numerous peer-reviewed manuscripts in high-impact medical journals. Dr Bahl is a passionate speaker who presents internationally on the complications of vascular access devices and strategies to improve patient outcomes
- Kim Alsbrooks has over 30 years of experience in the medical field. She started as a Radiologic Technologist then Registered Nurse, working on specialized hospital teams in Oncology and Vascular Access. She has worked at BARD/Becton, Dickinson, and Company, where she is now the Sr Director of Medical Affairs, for the past 20 years. Her work is mostly focused on vascular access evidence generation and research. Kim speaks across the US and internationally on vascular access topics
- Kelly Ann Zazyczny, BSN, RN, RT (R), VA-BC, is the director of nursing of the Psychiatric, Women, and Children's Division at Bryn Mawr Hospital, Vascular Access Nursing Services for the Main Line Health System. She has been a clinical leader for over 25 years, holding positions at Main Line Health, The Children's Hospital of Philadelphia, and Children's Healthcare of Atlanta. Her clinical focus has been on pediatrics, vascular access, radiology, and research. She has been named one of the Top Nurses in Nursing Management by Main Line Today for the last 3 years
- Steven Johnson, DO, is a board-certified emergency medicine physician and critical care fellow at the University of Southern California. He also conducts catheter-related research in his work as a research scientist at Beaumont Health. He developed a passion for improving peripheral venous access after witnessing firsthand how poor catheter performance affects patient outcomes and overall health
- Klaus Hoerauf, MD, PhD, currently serves as worldwide vice president of medical affairs, medication delivery solutions, at Becton, Dickinson, and Company. In this role, he leads Medical & Scientific Affairs and Health Economics and Outcomes Research departments. He has an MD and a Doctorate in Cardiology from the Medical University of Münster and has been appointed as associate professor of anesthesiology and intensive care medicine at the Medical University of Vienna, Austria. He is certified in anesthesiology and intensive care medicine, emergency medicine, and pain therapy
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Seetharam AM, Raju U, Suresh K. A randomized controlled study to compare first stick success with Instaflash technology: The FIRSST study. J Vasc Access 2024; 25:203-209. [PMID: 35220831 DOI: 10.1177/11297298221080369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Peripheral intravenous catheters (PIVCs) are frequently used in clinical settings for intravenous access. Multiple attempts of PIVC insertions leads to patient discomfort, delay in treatment, associated complications, and extensive expenditure cost. Reduced number of attempts causes patient/nursing personnel satisfaction and expenditure costs. The present study evaluated performance efficacy of BD Venflon™ I with Instaflash needle technology (investigational device) as compared to the BD Venflon™ without Instaflash needle technology (control device). METHODOLOGY The PIVC insertions were randomized in the ratio 1:1 using either investigational or control device and were monitored for first stick success rate, ease of insertion, and patient satisfaction. Data was analyzed using R 4.0.3 and Microsoft Excel. Chi square test was used to establish association between two categorical variables. RESULTS In total, 1402 patients were analyzed for first attempt insertion success which showed 98.72% success rate in investigational device as compared to 88.87% success rate in case of the control device (p = 0.0004). Marginal differences were observed in ease of insertion in investigational (98.71%) and control devices (99%) signifying high satisfaction levels of nursing personnels. Positive responses were observed in investigational (98.01%) and control devices (99%) underlining satisfactory performances of overall patient experiences. CONCLUSION The present study showed that BD Venflon™ I with Instaflash needle technology enhanced first attempt insertion success rate along with marginal differences in its efficacy in comparison with the BD Venflon™ without Instaflash needle technology thus enhancing patient and nursing personnel satisfaction in turn making it a better alternative to be used in hospitals.
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Affiliation(s)
- Arun Mavaji Seetharam
- Department of Hospital Administration, M S Ramaiah Medical College and Hospitals, Bangalore, India
| | - Umashankar Raju
- Department of Hospital Administration, M S Ramaiah Medical College and Hospitals, Bangalore, India
| | - K Suresh
- Department of Hospital Administration, M S Ramaiah Medical College and Hospitals, Bangalore, India
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Basak T, Demirtas A, Duman S. The effect of rose oil aromatherapy and hand-holding on pain due to peripheral intravenous catheter insertion. Explore (NY) 2024; 20:62-69. [PMID: 37301653 DOI: 10.1016/j.explore.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 06/12/2023]
Abstract
INTRODUCTION The study aimed to evaluate the effectiveness of rose oil (Rosa Damascene Mill.) aromatherapy and hand-holding in reducing pain associated with peripheral intravenous catheter insertion. METHODS A comparative mixed-method design. A total of 126 patients were included in the study. For the study's quantitative data, sociodemographic characteristics of the patients and the Patient Interview Form for the qualitative data of the Numeric Rating Scale were used. In all patients included in the study, PIVC insertion was performed a single time by the same nurse using a standard procedure. Chi-square and Bonferroni tests were used for comparative statistics. RESULTS No statistically significant difference between the groups regarding age, gender, marital status, BMI, and education level (p>0.05). Pain scores: it was 2.40±1.78 in the rose oil group, 3.53±1.98 in the hand-holding group, and 4.88±1.56 in the control group. The difference between the groups regarding pain scores is statistically significant (p=0.001). CONCLUSIONS The study determined that rose oil aromatherapy and hand-holding interventions reduce pain during PIVC. However, rose oil aromatherapy was more effective on pain than the hand-holding intervention. (Clinical Trial ID: NCT05425849).
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Affiliation(s)
- Tulay Basak
- University of Health Sciences Turkey, Gulhane Faculty of Nursing, Etlik, Ankara, Turkey.
| | - Ayla Demirtas
- University of Health Sciences Turkey, Gulhane Faculty of Nursing, Etlik, Ankara, Turkey
| | - Senem Duman
- University of Health Sciences Turkey, Gulhane Faculty of Nursing, Etlik, Ankara, Turkey
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Costa SPD, Silveira RED, Monteiro DAT, Contim D, Toffano SEM. Quality of care in peripheral venous catheterization: A scoping review. Rev Bras Enferm 2023; 76:e20220578. [PMID: 38055472 DOI: 10.1590/0034-7167-2022-0578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 07/23/2023] [Indexed: 12/08/2023] Open
Abstract
OBJECTIVE To map the current status of parameters and tools to assess quality of care related to peripheral venous catheter use in adults. METHODS Scoping review, conducted in 2022 in the MEDLINE, LILACS, CINAHL and SCOPUS databases and with a publication time limit from 2013 to 2022. RESULTS The sample consisted of 15 articles, summarized in the following categories: Indication, documentation and registration, coverage assessment, connection, stabilization and signs and symptoms inherent to the catheter. The use of a complete instrument, with the domains observed in this review, may have a positive impact on a more effective and safe clinical practice. CONCLUSIONS The present review mapped the evidence about the insertion and maintenance of peripheral venous catheters that can be improved with training of good practices and the quality of the team, regarding the use of tools, materials and instruments for the evaluation of care.
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Affiliation(s)
| | | | | | - Divanice Contim
- Universidade Federal do Triângulo Mineiro. Uberaba, Minas Gerais, Brazil
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Mielke N, Xing Y, Gibson SM, DiLoreto E, Bahl A. Bridging the Gap in Traditional PIVC Placement: An Evaluation of Operation STICK Vascular Access Outcomes. Ther Clin Risk Manag 2023; 19:937-948. [PMID: 38023627 PMCID: PMC10676087 DOI: 10.2147/tcrm.s435628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/04/2023] [Indexed: 12/01/2023] Open
Abstract
Objective Education and training is core to improving peripheral intravenous access outcomes. This study aimed to show that a vascular access training program (Operation STICK) in the emergency department (ED) improves the outcomes of traditionally placed peripheral intravenous catheters (PIVC). Methods This was a pre-post quasi-experimental study of traditionally placed PIVCs at a large ED in southeastern Michigan, United States. A control group (non-OSTICK) was compared to an experimental group (OSTICK) using a 3:1 propensity score matched analysis. Groups were comprised of ED patients with traditional PIVC placements in two separate six-month periods: non-OSTICK PIVCs from April to September 2021 and OSTICK PIVCs (placed by an OSTICK graduate) from October 2022 to March 2023. The primary outcome was PIVC functionality. The secondary outcome was adherence to best practices. Results A total of 6512 PIVCs were included in the study; 4884 (75.0%) were in the non-OSTICK group, while 1628 (25.0%) were in the OSTICK group. 68.1% of OSTICK PIVCs and 59.7% of non-OSTICK PIVCs were placed by ED technicians (p < 0.001). 91.3% of OSTICK PIVCs were placed on the first attempt, and 98.5% were placed within two attempts. A subgroup analysis of admitted patients (2540 PIVCs; 553 (21.8%) OSTICK-trained and 1987 (78.2%) non-OSTICK-trained) revealed 87.6% of OSTICK PIVCs and 80.3% of non-OSTICK PIVCs were 20 gauge (p < 0.001). The median proportion of dwell time to hospital length of stay was 94% for OSTICK PIVCs, compared to 88% for non-OSTICK PIVCs (p < 0.001). Conclusion This study underscores the value of education and training in enhancing vascular access outcomes. Implementing Operation STICK, a comprehensive vascular access training program, at a large ED has led to high first-stick success, adherence to best practice recommendations for site and device selection, and improved PIVC functionality for traditionally placed catheters.
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Affiliation(s)
- Nicholas Mielke
- Department of Medicine, Creighton University School of Medicine, Omaha, NE, USA
| | - Yuying Xing
- Corewell Health Research Institute, Royal Oak, MI, USA
| | | | - Emily DiLoreto
- Department of Emergency Medicine, Corewell Health William Beaumont University Hospital, Royal Oak, MI, USA
| | - Amit Bahl
- Department of Emergency Medicine, Corewell Health William Beaumont University Hospital, Royal Oak, MI, USA
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10
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Vadgaonkar A, Kothale N, Patil P, Kothari AH, Shetty YC. Factors determining success and the cost of materials used in securing intravenous access in an emergency setting: A prospective observational study. Int Emerg Nurs 2023; 71:101338. [PMID: 37716174 DOI: 10.1016/j.ienj.2023.101338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 07/17/2023] [Accepted: 08/03/2023] [Indexed: 09/18/2023]
Abstract
INTRODUCTION Multiple failed attempts at securing intravenous catheter access cause increased patient dissatisfaction and higher costs. We aimed to identify the factors leading to multiple failed attempts and estimate the cost of resources wasted. METHODS Participants were recruited from the emergency department for a prospective, observational study. Healthcare workers inserting peripheral intravenous catheters were observed. Patient characteristics and the number of attempts needed were recorded. RESULTS Three hundred thirty-four patients were enrolled, and an average of 1.74 ± 1.026 (Range: 1 - 5) access attempts were needed per patient. Only 56.28% of the insertions were successful on the first attempt. On multivariate linear regression with attempts as the outcome variable, age (β = 0.01, 95%CI 0.004 - 0.014, p = 0.0006), catheter calibre (β 20G = -0.25, 95%CI -0.45 - -0.07, p = 0.008), visibility (β = 0.23, 95%CI 0.02 - 0.44, p = 0.026) and palpability (β = 0.44, 95%CI 0.21 - 0.66, p = 0.0001) of the vein were statistically significant predictors. The average total cost of materials required was $6.4 USD per patient, of which $1.76 USD was spent towards unsuccessfully inserted catheters that were consequently thrown away. CONCLUSIONS Our study shows that securing IV access often requires multiple attempts, with nearly 30% of the total cost amounting towards materials wasted. The risk of multiple attempts is highest for older patients with invisible and non-palpable veins.
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Affiliation(s)
- Aditya Vadgaonkar
- Seth GS Medical College & KEM Hospital, Acharya Donde Marg, Parel, Mumbai 400012, India.
| | - Nikit Kothale
- Seth GS Medical College & KEM Hospital, Acharya Donde Marg, Parel, Mumbai 400012, India
| | - Prakash Patil
- Dept of Pharmacology and Therapeutics, Seth GS Medical College & KEM Hospital, Mumbai, India
| | - Abhi H Kothari
- Seth GS Medical College & KEM Hospital, Acharya Donde Marg, Parel, Mumbai 400012, India
| | - Yashashri C Shetty
- Dept of Pharmacology and Therapeutics, Seth GS Medical College & KEM Hospital, Mumbai, India
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11
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Dave J, Chand S, Gs R, Raj A, Sp P, Sivaprakasam M. Multispectral Imaging for Vein Localization and Contrast Enhancement. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-4. [PMID: 38083397 DOI: 10.1109/embc40787.2023.10341080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Intravenous (IV) catheterization is a common procedure. Still, there is a 26% chance of the first attempt catheterization failure due to the changing visibility of veins because of the patient's skin tone and body fat content. Ultrasound assistive devices help locate deeper veins but are not practical in emergencies, and transillumination assistive devices have a low field of view. Commercial near-infrared (NIR) imaging devices are effective in vein localization but are expensive and are not used in low-cost clinical settings. To overcome this, NIR Multispectral Imaging (MSI) was used to find the optimal wavelength that provides the enhanced visualization of veins for all skin types and Body Mass Index (BMI). The band with the highest vein-to-skin contrast ratio was selected and contrast enhancement was done using our proposed method. The primary blocks of the proposed method are Gamma correction, Contrast Limited Adaptive Histogram Equalization (CLAHE), Adaptive Thresholding, and image Fusion. The optimal spectral range was found to be 814-876 nm and our method increased the contrast by 0.41, 0.375, and 0.39 for fair, brown, and dark brown skin types, respectively, with different BMI.Clinical relevance- From the study, we can develop a potentially low-cost vein localization assistive device for training medical and nursing students and use it in emergencies for venous access to improve confidence in IV catheterization.
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12
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Xu W, Zhang Y, Wang Z, Dorsey SG, Starkweather A, Kim K. Pain self-management plus activity tracking and nurse-led support in adults with chronic low back pain: feasibility and acceptability of the problem-solving pain to enhance living well (PROPEL) intervention. BMC Nurs 2023; 22:217. [PMID: 37355622 DOI: 10.1186/s12912-023-01365-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 05/31/2023] [Indexed: 06/26/2023] Open
Abstract
BACKGROUND Chronic low back pain can lead to individual suffering, high medical expenditures, and impaired social well-being. Although the role of physical activity in pain management is well established, the underlying mechanisms of biological and clinical outcomes are unknown. This study aimed to assess the feasibility and acceptability of a pain self-management intervention, Problem-Solving Pain to Enhance Living Well, which employs wearable activity tracking technology and nurse consultations for people with chronic low back pain. METHODS This one-arm longitudinal study recruited 40 adults aged 18-60 years with chronic low back pain. Over 12 weeks, participants watched 10 short video modules, wore activity trackers, and participated in nurse consultations every 2 weeks. At baseline and the 12-week follow-up, they completed study questionnaires, quantitative sensory testing, and blood sample collection. RESULTS Forty participants were recruited, and their mean age was 29.8. Thirty-two participants completed the survey questionnaire, quantitative sensory testing, Fitbit activity tracker, and bi-weekly nurse consultation, and 25 completed the evaluation of biological markers. The overall satisfaction with the Problem-Solving Pain to Enhance Living Well video modules, nurse consultations, and Fitbit in pain management was rated as excellent. No adverse events were reported. Between the baseline and 12-week follow-up, there was a significant decrease in pain intensity and interference and an increase in the warm detection threshold at the pain site. CONCLUSIONS Despite concerns about the participant burden due to multidimensional assessment and intensive education, the feasibility of the Problem-Solving Pain to Enhance Living Well intervention was favorable. Technology-based self-management interventions can offer personalized strategies by integrating pain phenotypes, genetic markers, and physical activity types affecting pain conditions. TRIAL REGISTRATION This pilot study was registered with ClinicalTrials.gov [NCT03637998, August 20, 2018]. The first participant was enrolled on September 21, 2018.
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Affiliation(s)
- Wanli Xu
- University of Connecticut School of Nursing, Storrs, Connecticut, USA
- Center for Advancement in Managing Pain, University of Connecticut, Storrs, Connecticut, USA
| | - Yiming Zhang
- Department of Statistics, University of Connecticut, Storrs, Connecticut, USA
| | - Zequan Wang
- University of Connecticut School of Nursing, Storrs, Connecticut, USA
- Center for Advancement in Managing Pain, University of Connecticut, Storrs, Connecticut, USA
| | - Susan G Dorsey
- School of Nursing, University of Maryland, Baltimore, USA
| | | | - Kyounghae Kim
- College of Nursing, Korea University, 145 Anam-ro, Seongbuk-Gu, Seoul, South Korea.
- Nursing Research Institute, Korea University, Seoul, South Korea.
- BK21 FOUR R&E Center for Learning Health Systems, Korea University, Seoul, South Korea.
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13
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Steinwandel U, Coventry LL, Kheirkhah H. Evaluation of a Point-of-care ultrasound (POCUS) workshop for peripheral intravenous cannulation. BMC MEDICAL EDUCATION 2023; 23:451. [PMID: 37337172 DOI: 10.1186/s12909-023-04428-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 06/06/2023] [Indexed: 06/21/2023]
Abstract
BACKGROUND Point-of-care ultrasound (POCUS) is increasingly used as a non-invasive vascular access assessment method by clinicians from multiple disciplines worldwide, prior and during vascular access cannulations. While POCUS is a relatively new method to establish a vascular access in patients with complex vascular conditions, it is also essential to train and educate individuals who are novices in the techniques of cannulation so that they become proficient in performing this task subsequently on patients safely and successfully. A simulated environment may be a helpful tool to help healthcare providers establish skills in using POCUS safely and may also help them to successfully establish vascular access in patients. With this project, we sought to determine if participants of a simulated POCUS workshop for vascular access can use this technique successfully in their individual clinical environment after their attendance of a half-day workshop. METHODS A mixed-methods longitudinal study design was chosen to evaluate a point-of-care ultrasound workshop for peripheral intravenous cannula insertion. The workshops used simulation models for cannulation in combination with multiple ultrasound devices from various manufacturers to expose participants to a broader variety of POCUS devices as they may also vary in different clinical areas. Participants self-assessed their cannulation skills using questionnaires on a 10-point rating scale prior to and directly after the workshop. RESULTS A total of 85 Individuals participated in eleven half-day workshops through 2021 and 2022. Workshop participants claimed that attending the workshop had significantly enhanced their clinical skill of using ultrasound for the purpose of cannulating a venous vessel. The level of confidence in using this technique had increased in all participants directly after conclusion of the workshop. CONCLUSIONS Globally, clinicians are increasingly using POCUS to establish vascular access in patients, and it is necessary that they receive sufficient and adequately structured and formal training to successfully apply this technique in their clinical practice. Offering a workshop which uses simulation models in combination with various POCUS devices to demonstrate this technique in a hands-on approach has proven to be useful to establish this newly learned skill in clinicians.
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Affiliation(s)
- Ulrich Steinwandel
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, 6027, WA, Australia.
| | - Linda L Coventry
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, 6027, WA, Australia
- Centre for Research in Aged Care, Edith Cowan University, Joondalup, Australia
- Centre for Nursing Research, Sir Charles Gairdner Hospital, Nedlands, Australia
| | - Homa Kheirkhah
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, Joondalup, 6027, WA, Australia
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14
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Barsky D, Radomislensky I, Talmy T, Gendler S, Almog O, Avital G. Association Between Profound Shock Signs and Peripheral Intravenous Access Success Rates in Trauma Patients in the Prehospital Scenario: A Retrospective Study. Anesth Analg 2023; 136:934-940. [PMID: 37058730 DOI: 10.1213/ane.0000000000006342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
BACKGROUND Hemorrhage is the leading cause of preventable death in trauma patients, and establishment of intravenous (IV) access is essential for volume resuscitation, a key component in the treatment of hemorrhagic shock. IV access among patients in shock is generally considered more challenging, although data to support this notion are lacking. METHODS In this retrospective registry-based study, data were collected from the Israeli Defense Forces Trauma Registry (IDF-TR) regarding all prehospital trauma patients treated by IDF medical forces between January 2020 and April 2022, for whom IV access was attempted. Patients younger than 16 years, nonurgent patients, and patients with no detectable heart rate or blood pressure were excluded. Profound shock was defined as a heart rate >130 or a systolic blood pressure <90 mm Hg, and comparisons were made between patients with profound shock and those not exhibiting such signs. The primary outcome was the number of attempts required for first IV access success, which was regarded as an ordinal categorical variable: 1, 2, 3 and higher and ultimate failure. A multivariable ordinal logistic regression was performed to adjust for potential confounders. Patients' sex, age, mechanism of injury and best consciousness level, as well as type of event (military/nonmilitary), and the presence of multiple patients were included in the ordinal logistic regression multivariable analysis model based on previous publications. RESULTS Five hundred thirty-seven patients were included, 15.7% of whom were recorded as having signs of profound shock. Peripheral IV access establishment first attempt success rates were higher in the nonshock group, and there was a lower rate of unsuccessful attempts in this group (80.8% vs 67.8% for the first attempt, 9.4% vs 16.7% for the second attempt, 3.8% vs 5.6% for the third and further attempts, and 6% vs 10% unsuccessful attempts, P = .04). In the univariable analysis, profound shock was associated with requirement for an increased number of IV attempts (odds ratio [OR], 1.94; confidence interval [CI], 1.17-3.15). The ordinal logistic regression multivariable analysis demonstrated that profound shock was associated with worse results regarding primary outcome (adjusted odds ratio [AOR], 1.84; CI, 1.07-3.10). CONCLUSIONS The presence of profound shock in trauma patients in the prehospital scenario is associated with an increased number of attempts required for IV access establishment.
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Affiliation(s)
- Daniel Barsky
- From The Trauma and Combat Medicine Branch, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel
- Institute for Research in Military Medicine (IRMM), Faculty of Medicine, The Hebrew University of Jerusalem and the Israel Defense Forces Medical Corps, Jerusalem, Israel
| | - Irina Radomislensky
- From The Trauma and Combat Medicine Branch, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel
- The National Center for Trauma and Emergency Medicine Research, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel-HaShomer, Israel
| | - Tomer Talmy
- From The Trauma and Combat Medicine Branch, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel
- Department of Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Sami Gendler
- From The Trauma and Combat Medicine Branch, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel
| | - Ofer Almog
- From The Trauma and Combat Medicine Branch, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel
- Department of Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
- Division of Anesthesia, Intensive Care, and Pain Management, Tel-Aviv Medical Center, Tel-Aviv University, Tel-Aviv, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Guy Avital
- From The Trauma and Combat Medicine Branch, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel
- Division of Anesthesia, Intensive Care, and Pain Management, Tel-Aviv Medical Center, Tel-Aviv University, Tel-Aviv, Israel, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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15
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Yasuda K, Okada K, Sugimura N, Yano R. Do Tapping and Massaging during Tourniquet Application Promote Dilation of Forearm Cutaneous Veins? A Pilot Quasi-Experimental Study. Healthcare (Basel) 2023; 11:healthcare11040522. [PMID: 36833056 PMCID: PMC9956355 DOI: 10.3390/healthcare11040522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/18/2023] [Accepted: 02/08/2023] [Indexed: 02/12/2023] Open
Abstract
Successful insertion of a peripheral intravenous catheterization requires that veins be sufficiently dilated. This study aimed to clarify the venous dilation effect of including tapping or massaging to the application of a tourniquet at the cutaneous veins of healthy adults' forearms. This was a quasi-experimental study of 30 healthy adult volunteers. Each participant underwent all three venous dilation procedures, which included the tourniquet application (Control condition), the tourniquet application and tapping the participant's forearm (Tapping condition), as well as the tourniquet application combined with massaging the participant's forearm (Massage condition). To clarify the venous dilation effects, venous indices were measured, namely the venous diameter (mm), depth (mm), and palpation score. After applying all venous dilation procedures, the venous diameter and palpation score significantly increased. However, no significant difference was observed between the control condition and each intervention condition. The depth in the control and tapping conditions decreased significantly in contrast to the Massage condition. Moreover, a subgroup (nine participants with a venous diameter less than 3 mm after the control condition) had similar results. This study found that additional tapping or massaging after tourniquet application could be less effective in promoting dilation in the forearm veins of healthy adults. Future studies should examine the efficacy and effectiveness of venous dilation in a wide target population while considering intervention methods.
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Affiliation(s)
- Kae Yasuda
- Graduate School of Health Sciences, Hokkaido University, Sapporo 060-0812, Hokkaido, Japan
| | - Kazunori Okada
- Department of Clinical Laboratory Sciences, Faculty of Health Sciences, Japan Healthcare University, Sapporo 062-0053, Hokkaido, Japan
| | - Naotaka Sugimura
- Graduate School of Health Sciences, Hokkaido University, Sapporo 060-0812, Hokkaido, Japan
| | - Rika Yano
- Faculty of Health Sciences, Hokkaido University, Sapporo 060-0812, Hokkaido, Japan
- Correspondence:
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16
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New dimension on potential factors of successful pediatric peripheral intravenous catheterization. Pediatr Neonatol 2023; 64:19-25. [PMID: 35999154 DOI: 10.1016/j.pedneo.2022.05.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 04/14/2022] [Accepted: 05/10/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Peripheral intravenous catheterization (PIVC) is pivotal to pediatric medical care; however, it is a challenging technique for pediatricians, and the parameters affecting successful pediatric PIVC establishment have not been fully investigated. METHODS This prospective observational study collected data from pediatric patients aged less than 18 years who required PIVC. The participants were categorized into five groups for subgroup analysis: newborn, infant, toddler, pre-school, and student (children and adolescent). Data on demography, biochemistry, and PIVC executors were examined to elucidate the most powerful factors affecting the success of PIVC. RESULTS A total of 935 peripheral venous cannulations conducted within 1 year were studied. Age-subgroup analysis showed the highest failure rate (FR) of PIVC in the infant group (18.4%). No significant difference in BMI standard deviation score was noted among the groups (p-value = 0.430). Compared with those for the success group, more attempts, longer completion time, and more medical staff were needed for the failure group (all p-values < 0.05). A high serum procalcitonin level was correlated with an increased FR (p-value = 0.016). In addition, the success rate was positively associated with the seniority of the operators, except for the 3-year experienced R3 group (93.5%) showing a higher success rate than the 4-year experienced CR group (84.2%). CONCLUSIONS Difficulty in setting up PIVC was the greatest in infants and even greater than that in newborns. Even though seniority was a cardinal factor in successful PIVC, a high FR was still noted despite the lack of continuous and steady practice.
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17
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Chen JY. Peripheral intravenous cannulation in infants and children. Pediatr Neonatol 2023; 64:1-2. [PMID: 36564310 DOI: 10.1016/j.pedneo.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Affiliation(s)
- Jia-Yuh Chen
- Division of Neonatology, Changhua Christian Children's Hospital, Changhua, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan.
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18
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Abe-Doi M, Murayama R, Komiyama C, Tateishi R, Sanada H. Effectiveness of ultrasonography for peripheral catheter insertion and catheter failure prevention in visible and palpable veins. J Vasc Access 2023; 24:14-21. [PMID: 34075824 DOI: 10.1177/11297298211022078] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The increase in the success rate of peripheral intravenous catheterization against a difficult intravenous access (DIVA) using ultrasonography is reported; however, reports related to the effectiveness of using ultrasonography in increasing the success rate for visible and palpable veins is limited. Furthermore, according to a previous study, first attempt success in catheterization contributes to low catheter failure incidence. Thus, we developed a catheterization method using ultrasonography for peripheral veins including visible and palpable veins. This study investigates the effectiveness of ultrasonography use in improving the success rate of catheterization and preventing the catheter failure for peripheral veins including visible and palpable veins. METHODS Adult inpatients were recruited. Trained nurses inserted intravenous catheters using ultrasonography. Ultrasonography was used for all vein assessment, target vein selection, and puncturing (i.e. target point selection and/or needle guidance), regardless of the target vein's visibility or palpability. Catheters with over a 24-h dwelling time were followed for catheter failure incidence. RESULTS Thirty-one patients were recruited, and they required 34 catheterizations. Total number of catheterization attempts were 39. Of the peripheral veins, 51.3% (20/39) were visible and palpable, 48.7% (19/39) were DIVA. The rate of successful intravenous cannulation was 29 of 34 (85.3%) after one attempt and 4 of 34 (total 97.0%) after two attempts. The catheterization failure incidence was 3.2% (1/31) in the catheter that had an over 24-h dwelling time. CONCLUSIONS Using ultrasonography to all target veins might have contributed to higher success rates of catheterization and extremely low incidence of catheter failure based on objective findings. Selecting the vein with larger diameters and healthy tissue as puncture point and showing center of vessel lumen clearly using ultrasonography might have been contributed the results.
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Affiliation(s)
- Mari Abe-Doi
- Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.,Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Ryoko Murayama
- Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.,Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Chieko Komiyama
- Department of Nursing, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan
| | - Ryosuke Tateishi
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hiromi Sanada
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.,Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Paterson RS, Schults JA, Slaughter E, Cooke M, Ullman A, Kleidon TM, Keijzers G, Marsh N, Rickard CM. Review article: Peripheral intravenous catheter insertion in adult patients with difficult intravenous access: A systematic review of assessment instruments, clinical practice guidelines and escalation pathways. Emerg Med Australas 2022; 34:862-870. [PMID: 36038953 PMCID: PMC9804581 DOI: 10.1111/1742-6723.14069] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 07/31/2022] [Accepted: 08/08/2022] [Indexed: 01/05/2023]
Abstract
The optimal approach for peripheral intravenous catheter (PIVC) insertion in adult hospitalised patients with difficult intravenous access (DIVA) is unknown. The present study aimed to critically appraise the quality of (i) assessment instruments and (ii) clinical practice guidelines (CPGs) or escalation pathways for identifying and managing patients with DIVA. Cochrane Central Register of Controlled Trials, EBSCO MEDLINE, EMBASE (OVID) and EBSCO CINAHL databases were searched on 22 March 2021. Studies describing a DIVA assessment measure, CPG or escalation pathway for PIVC insertion in adults (≥18 years of age) were included. Data were extracted using a standardised data extraction form including study design, type of resource and reported clinical outcomes. Quality of DIVA assessment instruments were reviewed using the COnsensus-based Standards for the selection of health Measurement Instruments checklist. Methodological quality of CPGs and escalation pathways was assessed using the Appraisal of Guidelines for Research and Evaluation-II (AGREE-II) instrument. Overall, 24 DIVA resources comprising 16 DIVA assessment instruments and nine CPGs or escalation pathways (including one combined assessment instrument and escalation pathway) were identified. Instruments commonly focused on vein visibility and palpability as indicators of DIVA. CPGs and escalation pathways unanimously recommended use of vessel visualisation technology for patients with or suspected of DIVA. Methodological quality of the resources was mixed. Consensus and standardisation of resources to identify DIVA and recommendations for managing patients with DIVA is limited. Adopting consistent, evidence-based CPGs, escalation pathways or DIVA assessment instruments may significantly improve clinical outcomes.
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Affiliation(s)
- Rebecca S Paterson
- School of Nursing, Midwifery and Social WorkThe University of QueenslandBrisbaneQueenslandAustralia,Alliance of Vascular Access Teaching and ResearchSchool of Nursing and Midwifery, Griffith UniversityBrisbaneQueenslandAustralia
| | - Jessica A Schults
- School of Nursing, Midwifery and Social WorkThe University of QueenslandBrisbaneQueenslandAustralia,Alliance of Vascular Access Teaching and ResearchSchool of Nursing and Midwifery, Griffith UniversityBrisbaneQueenslandAustralia,Herston Infectious Diseases InstituteMetro North Hospital and Health Service, Queensland HealthBrisbaneQueenslandAustralia
| | - Eugene Slaughter
- School of Nursing, Midwifery and Social WorkThe University of QueenslandBrisbaneQueenslandAustralia
| | - Marie Cooke
- Alliance of Vascular Access Teaching and ResearchSchool of Nursing and Midwifery, Griffith UniversityBrisbaneQueenslandAustralia
| | - Amanda Ullman
- School of Nursing, Midwifery and Social WorkThe University of QueenslandBrisbaneQueenslandAustralia,Alliance of Vascular Access Teaching and ResearchSchool of Nursing and Midwifery, Griffith UniversityBrisbaneQueenslandAustralia,Queensland Children's HospitalChildren's Health Queensland Hospital and Health ServiceBrisbaneQueenslandAustralia
| | - Tricia M Kleidon
- School of Nursing, Midwifery and Social WorkThe University of QueenslandBrisbaneQueenslandAustralia,Alliance of Vascular Access Teaching and ResearchSchool of Nursing and Midwifery, Griffith UniversityBrisbaneQueenslandAustralia,Queensland Children's HospitalChildren's Health Queensland Hospital and Health ServiceBrisbaneQueenslandAustralia
| | - Gerben Keijzers
- Alliance of Vascular Access Teaching and ResearchSchool of Nursing and Midwifery, Griffith UniversityBrisbaneQueenslandAustralia,Emergency DepartmentGold Coast University HospitalGold CoastQueenslandAustralia,Faculty of Health Sciences and MedicineBond UniversityGold CoastQueenslandAustralia,School of MedicineGriffith UniversityGold CoastQueenslandAustralia
| | - Nicole Marsh
- School of Nursing, Midwifery and Social WorkThe University of QueenslandBrisbaneQueenslandAustralia,Alliance of Vascular Access Teaching and ResearchSchool of Nursing and Midwifery, Griffith UniversityBrisbaneQueenslandAustralia,Nursing and Midwifery Research CentreRoyal Brisbane and Women's HospitalBrisbaneQueenslandAustralia
| | - Claire M Rickard
- School of Nursing, Midwifery and Social WorkThe University of QueenslandBrisbaneQueenslandAustralia,Alliance of Vascular Access Teaching and ResearchSchool of Nursing and Midwifery, Griffith UniversityBrisbaneQueenslandAustralia,Herston Infectious Diseases InstituteMetro North Hospital and Health Service, Queensland HealthBrisbaneQueenslandAustralia,Nursing and Midwifery Research CentreRoyal Brisbane and Women's HospitalBrisbaneQueenslandAustralia
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Chen YM, Fan XW, Liu MH, Wang J, Yang YQ, Su YF. Risk factors for peripheral venous catheter failure: A prospective cohort study of 5345 patients. J Vasc Access 2022; 23:911-921. [PMID: 33985394 PMCID: PMC9585540 DOI: 10.1177/11297298211015035] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
PURPOSE The objective of this study was to determine the independent risk factors associated with peripheral venous catheter (PVC) failure and develop a model that can predict PVC failure. METHODS This prospective, multicenter cohort study was carried out in nine tertiary hospitals in Suzhou, China between December 2017 and February 2018. Adult patients undergoing first-time insertion of a PVC were observed from catheter insertion to removal. Logistic regression was used to identify the independent risk factors predicting PVC failure. RESULTS This study included 5345 patients. The PVC failure rate was 54.05% (n = 2889/5345), and the most common causes of PVC failure were phlebitis (16.3%) and infiltration/extravasation (13.8%). On multivariate analysis, age (45-59 years: OR, 1.295; 95% CI, 1.074-1.561; 60-74 years: OR, 1.375; 95% CI, 1.143-1.654; ⩾75 years: OR, 1.676; 95% CI, 1.355-2.073); department (surgery OR, 1.229; 95% CI, 1.062-1.423; emergency internal/surgical ward OR, 1.451; 95% CI, 1.082-1.945); history of venous puncture in the last week (OR, 1.298, 95% CI 1.130-1.491); insertion site, number of puncture attempts, irritant fluid infusion, daily infusion time, daily infusion volume, and type of sealing liquid were independent predictors of PVC failure. Receiver operating characteristic curve analysis indicated that a logistic regression model constructed using these variables had moderate accuracy for the prediction of PVC failure (area under the curve, 0.781). The Hosmer-Lemeshow goodness of fit test demonstrated that the model was correctly specified (χ2 = 2.514, p = 0.961). CONCLUSION This study should raise awareness among healthcare providers of the risk factors for PVC failure. We recommend that healthcare providers use vascular access device selection tools to select a clinically appropriate device and for the timely detection of complications, and have a list of drugs classified as irritants or vesicants so they can monitor patients receiving fluid infusions containing these drugs more frequently.
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Affiliation(s)
- Ya-mei Chen
- Department of Emergency, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiao-wen Fan
- Nursing College, Soochow University, Suzhou, China
| | - Ming-hong Liu
- Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jie Wang
- Department of Nursing, The First Affiliated Hospital of Soochow University, Medical Centre of Soochow University, Suzhou, China
| | - Yi-qun Yang
- Department of Nursing, The First Affiliated Hospital of Soochow University, Medical Centre of Soochow University, Suzhou, China,Yi-qun Yang, Department of Nursing, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou 215006, China.
| | - Yu-fang Su
- Department of Orthopaedic, The First Affiliated Hospital of Soochow University, Suzhou, China
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21
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Pre-hospital peripheral intravenous catheter insertion practice: An integrative review. Australas Emerg Care 2022:S2588-994X(22)00067-7. [DOI: 10.1016/j.auec.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/21/2022] [Indexed: 11/15/2022]
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22
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Lemieux E, Babyak J, Weaver Babyak S, Rozanski E, Frank N. Variables Influencing Intravenous Catheterization Success by Final-Year Veterinary Students in the Emergency Room. JOURNAL OF VETERINARY MEDICAL EDUCATION 2022; 50:e20210142. [PMID: 35797484 DOI: 10.3138/jvme-2021-0142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Successful placement of intravenous catheters (IVC) is a basic and essential clinical skill for veterinary students. The purposes of this study were to determine the overall success rate for IVC placement in cats and dogs when final-year veterinary students are performing the procedure in a clinical setting, to determine if self-assessed experience level affects IVC placement success rates, and to identify factors affecting student success with this procedure. Final-year students were asked to complete an anonymous survey following each catheter placement attempt during their 3-week core emergency medicine rotation. The survey included self-assessed level of experience, patient species, indication for IVC placement, restrainer, catheter type, insertion site, use of sedation, and perceived degree of coaching. Success or failure in catheter placement was recorded and two attempts were allowed. A Chi-square test was used to evaluate differences between insertion outcomes in dogs and cats. A univariate logistic regression analysis was used to assess the relationship between success and all other variables. A total of 256 catheters were attempted by students, with an overall success rate of 61%. The cephalic vein was associated with successful placement compared with the saphenous vein (p = .005). There was no relationship between successful catheter placement and self-assessed experience, species, indication for IVC placement, insertion site, use of sedation, catheter type, or restrainer. Final-year veterinary students do not master intravenous catheterization in the emergency room setting, and additional studies are required to improve clinical instruction in this area.
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Leipheimer J, Balter M, Chen A, Yarmush M. Design and Evaluation of a Handheld Robotic Device for Peripheral Catheterization. J Med Device 2022; 16:021015. [PMID: 35284032 PMCID: PMC8905093 DOI: 10.1115/1.4053688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 01/14/2022] [Indexed: 08/30/2024] Open
Abstract
Medical robots provide enhanced dexterity, vision, and safety for a broad range of procedures. In this article, we present a handheld, robotic device capable of performing peripheral catheter insertions with high accuracy and repeatability. The device utilizes a combination of ultrasound imaging, miniaturized robotics, and machine learning to safely and efficiently introduce a catheter sheath into a peripheral blood vessel. Here, we present the mechanical design and experimental validation of the device, known as VeniBot. Additionally, we present results on our ultrasound deep learning algorithm for vessel segmentation, and performance on tissue-mimicking phantom models that simulate difficult peripheral catheter placement. Overall, the device achieved first-attempt success rates of 97 ± 4% for vessel punctures and 89 ± 7% for sheath cannulations on the tissue mimicking models (n = 240). The results from these studies demonstrate the viability of a handheld device for performing semi-automated peripheral catheterization. In the future, the use of this device has the potential to improve clinical workflow and reduce patient discomfort by assuring a safe and efficient procedure.
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Affiliation(s)
| | - Max Balter
- Rutgers University, Piscataway, NJ 08854
| | - Alvin Chen
- Rutgers University, Piscataway, NJ 08854
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24
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Mörgeli R, Schmidt K, Neumann T, Kruppa J, Föhring U, Hofmann P, Rosenberger P, Falk E, Boemke W, Spies C. A comparison of first-attempt cannulation success of peripheral venous catheter systems with and without wings and injection ports in surgical patients-a randomized trial. BMC Anesthesiol 2022; 22:88. [PMID: 35361115 PMCID: PMC8969381 DOI: 10.1186/s12871-022-01631-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A peripheral venous catheter (PVC) is the most widely used device for obtaining vascular access, allowing the administration of fluids and medication. Up to 25% of adult patients, and 50% of pediatric patients experience a first-attempt cannulation failure. In addition to patient and clinician characteristics, device features might affect the handling and success rates. The objective of the study was to compare the first-attempt cannulation success rate between PVCs with wings and a port access (Vasofix® Safety, B. Braun, abbreviated hereon in as VS) with those without (Introcan® Safety, B. Braun, abbreviated hereon in as IS) in an anesthesiological cohort. METHODS An open label, multi-center, randomized trial was performed. First-attempt cannulation success rates were examined, along with relevant patient, clinician, and device characteristics with univariate and multivariate analyses. Information on handling and adherence to use instructions was gathered, and available catheters were assessed for damage. RESULTS Two thousand three hundred four patients were included in the intention to treat analysis. First-attempt success rate was significantly higher with winged and ported catheters (VS) than with the non-winged, non-ported design (IS) (87.5% with VS vs. 78.2% with IS; PChi < .001). Operators rated the handling of VS as superior (rating of "good" or "very good: 86.1% VS vs. 20.8% IS, PChi < .001). Reinsertion of the needle into the catheter after partial withdrawal-prior or during the catheterization attempt-was associated with an increased risk of cannulation failure (7.909, CI 5.989-10.443, P < .001 and 23.023, CI 10.372-51.105, P < .001, respectively) and a twofold risk of catheter damage (OR 1.999, CI 1.347-2.967, P = .001). CONCLUSIONS First-attempt cannulation success of peripheral, ported, winged catheters was higher compared to non-ported, non-winged devices. The handling of the winged and ported design was better rated by the clinicians. Needle reinsertions are related to an increase in rates of catheter damage and cannulation failure. TRIAL REGISTRATION ClinicalTrials.gov, Identifier: NCT02213965 , Date: 12/08/2014.
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Affiliation(s)
- Rudolf Mörgeli
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin Institute of Health, Charitépl. 1, 10117, Berlin, Germany
| | - Katrin Schmidt
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin Institute of Health, Charitépl. 1, 10117, Berlin, Germany
| | - Tim Neumann
- Department of Anesthesiology and Operative Intensive Care Medicine (CBF), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Jochen Kruppa
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin Institute of Health, Charitépl. 1, 10117, Berlin, Germany
| | - Ulrich Föhring
- Department of Anesthesiology and Operative Intensive Care Medicine (CBF), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Pascal Hofmann
- Universitätsklinik Für Anästhesiologie Und Intensivmedizin Tübingen, Universitätsklinikum Tübingen, 72076, Tübingen, Germany
| | - Peter Rosenberger
- Universitätsklinik Für Anästhesiologie Und Intensivmedizin Tübingen, Universitätsklinikum Tübingen, 72076, Tübingen, Germany
| | - Elke Falk
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin Institute of Health, Charitépl. 1, 10117, Berlin, Germany
| | - Willehad Boemke
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin Institute of Health, Charitépl. 1, 10117, Berlin, Germany
| | - Claudia Spies
- Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, Berlin Institute of Health, Charitépl. 1, 10117, Berlin, Germany.
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Omkar Prasad R, Chew T, Giri JR, Hoerauf K. Patient Experience With Vascular Access Management Informs Satisfaction With Overall Hospitalization Experience. JOURNAL OF INFUSION NURSING 2022; 45:95-103. [PMID: 35272306 PMCID: PMC8920007 DOI: 10.1097/nan.0000000000000460] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Peripheral intravenous catheter (PIVC) insertion is a common invasive procedure performed during hospitalization. The present study reports results from a survey of 544 patients who have had PIVC insertion during their hospital stay in Singapore and the Philippines during the period between November 2018 and February 2019. The survey assessed the importance of 5 domains of patient-centered care on patient satisfaction with their hospitalization experience, including pain management, infection prevention, health care provider competence with vascular access, physical comfort, and effectiveness of communication during vascular access management. Health care provider competence, infection prevention, and pain management ranked as the most important determinants of patient satisfaction. Patients were more likely to lose their trust in health care providers and express anxiety if they experienced multiple needle insertion attempts or PIVC-related complications, whereas patients who were satisfied with their PIVC insertion were more likely to express satisfaction with their overall hospital stay. Improving vascular access management with a focus on enhancing vascular access skills, infection prevention, and pain management may improve patient satisfaction.
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Affiliation(s)
- Rohini Omkar Prasad
- The Economist Intelligence Unit, The Economist Group, Singapore (Dr Prasad and Mr Chew); Becton Dickinson Central South Asia and Japan, Singapore (Dr Giri); Medical University of Vienna, Vienna, Austria (Dr Hoerauf); Becton Dickinson, Franklin Lakes, New Jersey (Dr Hoerauf)
- Rohini Omkar Prasad, MBBS, MPH, is a senior manager of health policy and clinical evidence at the Economist Intelligence Unit in Singapore. In her role, Dr Prasad manages health policy and clinical evidence projects across the Asia region
- Timothy Chew, BSc, is currently manager of regional new product planning at Menarini Asia-Pacific, Singapore. He was previously a senior associate consultant at the Economist Intelligence Unit, Singapore, at the time the study was conducted. In that role, Mr Chew managed a wide range of research and consulting projects across clients in health care services and medical devices
- Jayant R. Giri, MD, is an associate director at Becton Dickinson, Singapore, and is responsible for Medical Affairs for Becton Dickinson in Central South Asia and Japan. Dr Giri is also a certified health care quality assessor by the Quality Council of India
- Klaus Hoerauf, MD, PhD, DBA, currently serves as world-wide vice president, medical affairs, medication delivery solutions, at Becton Dickinson, USA, and holds a professorship at the Medical University of Vienna (Austria). In this role, Dr Hoerauf leads medical and scientific affairs with the main responsibility for innovation and evidence generation
| | - Timothy Chew
- The Economist Intelligence Unit, The Economist Group, Singapore (Dr Prasad and Mr Chew); Becton Dickinson Central South Asia and Japan, Singapore (Dr Giri); Medical University of Vienna, Vienna, Austria (Dr Hoerauf); Becton Dickinson, Franklin Lakes, New Jersey (Dr Hoerauf)
- Rohini Omkar Prasad, MBBS, MPH, is a senior manager of health policy and clinical evidence at the Economist Intelligence Unit in Singapore. In her role, Dr Prasad manages health policy and clinical evidence projects across the Asia region
- Timothy Chew, BSc, is currently manager of regional new product planning at Menarini Asia-Pacific, Singapore. He was previously a senior associate consultant at the Economist Intelligence Unit, Singapore, at the time the study was conducted. In that role, Mr Chew managed a wide range of research and consulting projects across clients in health care services and medical devices
- Jayant R. Giri, MD, is an associate director at Becton Dickinson, Singapore, and is responsible for Medical Affairs for Becton Dickinson in Central South Asia and Japan. Dr Giri is also a certified health care quality assessor by the Quality Council of India
- Klaus Hoerauf, MD, PhD, DBA, currently serves as world-wide vice president, medical affairs, medication delivery solutions, at Becton Dickinson, USA, and holds a professorship at the Medical University of Vienna (Austria). In this role, Dr Hoerauf leads medical and scientific affairs with the main responsibility for innovation and evidence generation
| | - Jayant R. Giri
- The Economist Intelligence Unit, The Economist Group, Singapore (Dr Prasad and Mr Chew); Becton Dickinson Central South Asia and Japan, Singapore (Dr Giri); Medical University of Vienna, Vienna, Austria (Dr Hoerauf); Becton Dickinson, Franklin Lakes, New Jersey (Dr Hoerauf)
- Rohini Omkar Prasad, MBBS, MPH, is a senior manager of health policy and clinical evidence at the Economist Intelligence Unit in Singapore. In her role, Dr Prasad manages health policy and clinical evidence projects across the Asia region
- Timothy Chew, BSc, is currently manager of regional new product planning at Menarini Asia-Pacific, Singapore. He was previously a senior associate consultant at the Economist Intelligence Unit, Singapore, at the time the study was conducted. In that role, Mr Chew managed a wide range of research and consulting projects across clients in health care services and medical devices
- Jayant R. Giri, MD, is an associate director at Becton Dickinson, Singapore, and is responsible for Medical Affairs for Becton Dickinson in Central South Asia and Japan. Dr Giri is also a certified health care quality assessor by the Quality Council of India
- Klaus Hoerauf, MD, PhD, DBA, currently serves as world-wide vice president, medical affairs, medication delivery solutions, at Becton Dickinson, USA, and holds a professorship at the Medical University of Vienna (Austria). In this role, Dr Hoerauf leads medical and scientific affairs with the main responsibility for innovation and evidence generation
| | - Klaus Hoerauf
- Corresponding Author: Klaus Hoerauf, MD, PhD, DBA, Becton Dickinson, USA, 1 Becton Dr, Franklin Lakes, NJ 07417 ()
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Indarwati F, Munday J, Keogh S. Nurse knowledge and confidence on peripheral intravenous catheter insertion and maintenance in pediatric patients: A multicentre cross-sectional study. J Pediatr Nurs 2022; 62:10-16. [PMID: 34798582 DOI: 10.1016/j.pedn.2021.11.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/31/2021] [Accepted: 11/05/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE To examine nursing knowledge and confidence of peripheral intravenous catheter insertion and maintenance in pediatric patients. DESIGN AND METHODS An online survey using validated questionnaires was conducted in ten (tertiary and district) hospitals in Indonesia from May to September 2020. Multivariable general linear models were used to investigate associations between nurses' characteristics and knowledge and confidence on the catheter insertion and maintenance score. RESULTS A total of 413 out of 458 pediatric nurses completed the survey (a response rate of 90%). The mean score of the nurse knowledge on insertion was 18.9(±3.3) (maximum score: 21), and the maintenance score was 6.5(±2.0) (maximum score: 12). The median score of the nurse insertion and maintenance confidence was quite high: 44 (IQR = 7) out of 50 and 37 (IQR = 4) out of 45, respectively. Initial patient assessment, catheter securement, site assessment and management of complications are areas where nurse knowledge and confidence are still lacking. Adjusted analysis indicates that training and work experience were significantly associated with the knowledge and confidence score (p < 0.05). CONCLUSION Pediatric nurses were largely confident in their skills but this was not reflected in their knowledge scores. Training and experience were important predictors for nursing knowledge and confidence in catheter insertion and maintenance. PRACTICE IMPLICATIONS The results provide nursing and hospital managers and educational institutions to understand areas of intravenous catheter insertion and maintenance in which nurses lack of knowledge and confidence as well as to formulate tailored and ongoing training to improve nurse knowledge, confidence, practices and optimize patients' care.
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Affiliation(s)
- Ferika Indarwati
- Queensland University of Technology (QUT), Faculty of Health, School of Nursing, Centre for Healthcare Transformation, Brisbane, Queensland, Australia; School of Nursing, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia.
| | - Judy Munday
- Queensland University of Technology (QUT), Faculty of Health, School of Nursing, Centre for Healthcare Transformation, Brisbane, Queensland, Australia; Faculty of Health and Sports Sciences, University of Agder, Grimstad, Norway; Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia.
| | - Samantha Keogh
- Queensland University of Technology (QUT), Faculty of Health, School of Nursing, Centre for Healthcare Transformation, Brisbane, Queensland, Australia; Alliance of Vascular Access Teaching and Research Group, Menzies Health Institute, Griffith University, Queensland, Australia.
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Lopes M, Torre-Montero JCDL, Peterlini MAS, Pedreira MDLG. Validation of the Brazilian Portuguese version of the Venous International Assessment Scale and proposal of revision. Rev Bras Enferm 2022; 75:e20220100. [DOI: 10.1590/0034-7167-2022-0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 07/06/2022] [Indexed: 11/07/2022] Open
Abstract
ABSTRACT Objective: To validate the Brazilian Portuguese translation and analyze the cultural adaptation of the Venous International Assessment Scale. Methods: Observational study by employing the Delphi technique and an equivalence evaluation by experts. The results were analyzed using item scores and by content validity index calculations of item, scale, and universal agreement. Results: Three rounds of evaluation were necessary for consensus. Explanatory contents were incorporated into the original scale throughout the process, resulting in a new version: VIA Scale - Revised. This scale obtained a content validity index of 0.96 and a universal agreement of 0.78. In the cross-cultural adequacy analysis phase, a score of 0.77 was obtained. The majority (90.5%) of the participants judged the scale’s decision support property as positive. Conclusion: The VIA Scale was validated and culturally adapted to the Brazilian Portuguese language, resulting in the VIA Scale - Revised (VIA-R).
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Bian Y, Huang Y, Bai J, Zheng J, Huang Y. A randomized controlled trial of ultrasound-assisted technique versus conventional puncture method for saphenous venous cannulations in children with congenital heart disease. BMC Anesthesiol 2021; 21:131. [PMID: 33906601 PMCID: PMC8077689 DOI: 10.1186/s12871-021-01349-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 04/16/2021] [Indexed: 11/16/2022] Open
Abstract
Background The study investigated the success rate of the great saphenous venous catheter placement performed by ultrasound-assisted technique compared with the conventional puncture method in infants and toddlers with congenital heart disease and aimed to assess the efficiency and feasibility of this method within the context of pediatric peripheral venous access. Methods We selected infants and toddlers who underwent congenital cardiac surgery in our medical center from June 1, 2020, to September 7, 2020, by convenience sampling. Children were stratified by the presence of the manifesting cardiac types (cyanotic or acyanotic heart disease). They were assigned to the conventional puncture method group or the ultrasound-assisted group through randomly blocked randomization. The primary outcome was the success rate of the first attempt. The second outcomes included the time to cannulation at the first attempt, the redirections of the first attempt, overall puncture time, and overall redirections of efforts. Besides, a binary logistic regression model was implemented to identify the possible variables related to the success rate of the first attempt. Results A total of 144 children in our medical center were recruited in the study. The success rate of the first attempt in the ultrasound-assisted group was higher than that of the conventional puncture method group in the stratification of cyanotic children (66.7% vs. 33.3%, P = 0.035). Among children of acyanotic kind, the difference in the success rate of the first attempt between the two groups was not significant (57.6% vs. 42.4%, P = 0.194). Overall puncture time (45.5 s vs. 94 s, P = 0.00) and the time to cannulation at the first attempt (41.0 s vs. 60 s, P = 0.00) in the ultrasound-assisted group was less than the conventional puncture method group. The ultrasound-assisted group also required fewer redirections of the first attempt (three attempts vs. seven attempts, P = 0.002) and fewer total redirections of efforts (two attempts vs. three attempts, P = 0.027) than the conventional puncture method group. The result of binary Logistic regression showed that the success rate of the first attempt was related to age (OR:1.141; 95% CI = 1.010–1.290, P = 0.034), the redirections of the first attempt (OR:0.698; 95% CI = 0.528–0.923, P = 0.012) and the saphenous venous width (OR:1.181; 95% CI = 1.023–1.364, P = 0.023). Conclusions The ultrasound-assisted technique improves the saphenous venous cannulation sufficiently in children with difficult peripheral veins. The younger age is associated with a higher likelihood of peripheral venous difficulty. The ultrasound-assisted methods can effectively screen peripheral veins, e.g., selecting thicker diameter peripheral veins, making puncture less uncomfortable, and improving success rates. This method can be used as one of the effective and practical ways of peripheral venipuncture in children, especially in difficult situations. It should be widely applied as one of the alternative ultrasound techniques in the operating room. Trial registration ChiCTR.org.cn (ChiCTR-2,000,033,368). Prospectively registered May 29, 2020.
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Affiliation(s)
- Yong Bian
- Department of Anesthesiology, Shanghai Children's Medical Center Affiliated to School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Road, Pudong, Shanghai, 200127, China
| | - Yanhui Huang
- Department of Anesthesiology, Shanghai Children's Medical Center Affiliated to School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Road, Pudong, Shanghai, 200127, China
| | - Jie Bai
- Department of Anesthesiology, Shanghai Children's Medical Center Affiliated to School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Road, Pudong, Shanghai, 200127, China
| | - Jijian Zheng
- Department of Anesthesiology and Pediatric Clinical Pharmacology Laboratory, Shanghai Children's Medical Center Affiliated to School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yue Huang
- Department of Anesthesiology, Shanghai Children's Medical Center Affiliated to School of Medicine, Shanghai Jiao Tong University, 1678 Dongfang Road, Pudong, Shanghai, 200127, China.
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Abstract
Short peripheral catheter (SPC) insertion is a common invasive procedure performed in hospitalized patients. Variations in this fundamental nursing skill exist among nurses, with significant impacts on budgets, patient satisfaction, and worker safety―key concerns for nurse leaders. A performance improvement project focused on vascular access management was undertaken, with the goal to improve SPC practice and associated outcomes. Assessment of current SPC policies, practices, products, and outcomes identified areas of potential improvement. A performance improvement program was undertaken, and its effects on clinical, safety, and economic outcomes were assessed at 5 hospitals in 1 health care system. Clinical, safety, and economic outcomes improved, as demonstrated by longer average catheter dwell times, increased first-insertion success, improved patient satisfaction, reduced blood exposure, and annual cost savings. A vascular access management program can support leaders in achieving consistent guideline adherent practice among nurses while reducing cost and increasing patient and nurse satisfaction.
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Parker SI, Simmons SM, Rutherford A, Caird JK, Benzies KM. Novice and Expert Nurses’ Eye Movements and Success With Simulated Peripheral Intravenous Catheterization. Clin Simul Nurs 2021. [DOI: 10.1016/j.ecns.2020.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Salvetti M, Paini A, Colonetti E, Mutti C, Bonetti S, Broggi A, Bertacchini F, Muiesan ML. Intravenous access placement and fluid administration appropriateness in the emergency department. EMERGENCY CARE JOURNAL 2021. [DOI: 10.4081/ecj.2021.9150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The aim of this study is to assess practice and effectiveness of Peripheral Venous Catheter (PVC) insertion and intravenous fluid administration in the Emergency Department (ED). A prospective study was conducted at a single primary ED in Brescia, Italy. 455 participants were included in the analysis. PVC were placed in 88 % of patients, 18 gauge catheters were the most frequently used (63%). In 360 patients PVC placement required one attempt. In 99 % of patients PVCs were used at least once. Fluid administration was considered appropriate in 23 patients. Out of 402 PVC placements, 244 were not necessary (in 225 patients PVCs were used only for blood samples withdrawal, and in 16 patients they were used for blood samples withdrawal, and inappropriate fluid administration). We concluded that a large number of PVC placements in the ED was potentially avoidable, and, when PVCs were used for IV fluid administration, the indication was often inappropriate. Physicians should carefully assess the real need of PVC placement in patients admitted to the ED and critically assess some issues of everyday practice, like PVC placement or IV fluids prescription, with evaluation of cost savings.
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Pedreira-Robles G, Martínez-Delgado Y, Herrera-Morales C, Vasco-Gómez A, Junyent-Iglesias E. Analysis of experience of the use of plastic cannulas in Spanish haemodialysis units. J Ren Care 2020; 47:43-50. [PMID: 33111496 DOI: 10.1111/jorc.12348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 04/19/2020] [Accepted: 05/08/2020] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Plastic cannulas (PC) have shown efficacy in haemodialysis (HD) and are presented as a positive innovation for patients and vascular access survival. OBJECTIVE To analyse Spanish HD nurses' experience of using PC. DESIGN Cross-sectional observational study. METHODS An ad hoc questionnaire was administered on nurses' experience of PC use. RESULTS A total of 163 Spanish HD nurses were surveyed, of whom 42.3% had PC in their workplace and 50.9% had used them. In all, 55.8% had received training and 77.9% wished to receive more training. These needles were significantly more available in public institutions than in private centres (p < 0.001). There was no significant difference between years of experience and having received training (p = 0.915). There was a moderate-strong correlation (ρ = 0.659) between greater professional satisfaction with the product and greater patient satisfaction (p < 0.001). The nurses would make a median of two [P25 , 1; P75 , 3] modifications in the product design. The characteristics of the PC were rated positively by 55.8% and negatively by 10.3%. CONCLUSIONS A substantial proportion of the nurses surveyed did not use PC and had not received training in their use. Respondents reported that PC could be improved and a small percentage perceived them negatively. IMPLICATIONS FOR PRACTICE Based on the evidence presented and available, if we manage to integrate this knowledge and work on the continuum of achieving excellence, we will continue to grow as a profession and provide higher quality care.
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Translation and Validation of the Modified A-DIVA Scale to European Portuguese: Difficult Intravenous Access Scale for Adult Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207552. [PMID: 33080802 PMCID: PMC7589933 DOI: 10.3390/ijerph17207552] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/10/2020] [Accepted: 10/14/2020] [Indexed: 11/17/2022]
Abstract
(1) Background: In Portugal, no accurate and reliable predictive instruments are known that could assist healthcare professionals in recognizing patients with difficult venous access. Thus, this study aimed to translate and validate the Modified A-DIVA scale to European Portuguese. (2) Methods: A methodological and cross-sectional study was conducted in two phases: translation of the Modified A-DIVA scale to European Portuguese following six stages proposed by Beaton and collaborators, and assessment of its psychometric properties in a non-probability sample of 100 patients who required peripheral intravenous catheterization in a Portuguese hospital. (3) Results: The European version of the Modified A-DIVA scale (A-DM scale) showed excellent inter-rater accordance scores, k = 0.593 (95% CI, 0.847 to 0.970), p < 0.0005. The A-DM scale's criterion and construct validity was assessed through predictive, convergent, and correlational analysis with variables identified in the literature as associated with difficult peripheral intravenous access, with moderate to large magnitudes and statistical significance. (4) Conclusions: The A-DM scale is a reliable and valid instrument that can support healthcare professionals and researchers in the early identification of patients at risk of difficult peripheral intravenous access. Future validation studies are needed to test the A-DM scale's applicability across clinical settings and in different patient cohorts.
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Rodriguez-Calero MA, de Pedro-Gomez JE, Molero-Ballester LJ, Fernandez-Fernandez I, Matamalas-Massanet C, Moreno-Mejias L, Blanco-Mavillard I, Moya-Suarez AB, Personat-Labrador C, Morales-Asencio JM. Risk Factors for Difficult Peripheral Intravenous Cannulation. The PIVV2 Multicentre Case-Control Study. J Clin Med 2020; 9:E799. [PMID: 32183475 PMCID: PMC7141318 DOI: 10.3390/jcm9030799] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/09/2020] [Accepted: 03/13/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Difficult peripheral intravenous cannulation (DPIVC) is associated with serious complications related to vascular access. These complications might be avoided if the risk factors were identified previously, enabling the detection of potentially difficult situations at an early stage. The aim of this study is to consider these risk factors, to determine the influence of the hospital setting, to examine the association between DPIVC and the different techniques of catheter insertion and to analyse the importance of the clinician's experience in this context. METHODS Case-control study following a previously published protocol, conducted in 48 units of eight public hospitals in Spain. Adult patients requiring a peripheral intravenous cannula were prospectively included in the study population during their hospital stay. Over a period of 11 months, for consecutive eligible patients, nurses in each participating unit recorded data on their assessment of the vascular access performed and the technique used. Variables related to these medical personnel were also recorded. One of the researchers reviewed the patients' clinical history to compile the relevant health variables and to characterise the healthcare process. The statistical analysis included association tests among the main study variables. The risk factors were analysed using bivariate logistic regression. The variables found to be statistically significant were included in a multivariate logistic regression model incorporating each of the healthcare environments identified. RESULTS The study population was composed of 2662 patients, of whom 221 (8.3%) presented with DPIVC. A previous history of difficulty, the presence of non-palpable veins, acute upper limb alterations and punctures in the ante-cubital fossa were found to be independent risk factors for DPIVC. Differences were found in the frequency of occurrence of DPIVC and in some risk factors, according to the healthcare context. The variables related to the characteristics of the hospital personnel did not influence the study event. CONCLUSION The present study identifies four independent risk factors for DPIVC that can be incorporated into algorithms aimed at preventing its occurrence and facilitating the referral of patients to vascular access specialist teams.
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Affiliation(s)
- Miguel Angel Rodriguez-Calero
- Nurse Director Office, Health System of the Balearic Islands (Ib-Salut), Carrer de la Reina Esclaramunda, 9. Piso 3, 07003 Palma Mallorca, Spain
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Ctra Palma-Valldemossa km 7.5, 07121 Palma Mallorca, Spain; (J.E.d.P.-G.); (I.B.-M.); (C.P.-L.)
- Balearic Islands Health Research Institute (IdISBa), Ctra Valldemossa, 79. Hospital Universitari Son Espases, edifici S, 07120 Palma de Mallorca, Spain
| | - Joan Ernest de Pedro-Gomez
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Ctra Palma-Valldemossa km 7.5, 07121 Palma Mallorca, Spain; (J.E.d.P.-G.); (I.B.-M.); (C.P.-L.)
- Balearic Islands Health Research Institute (IdISBa), Ctra Valldemossa, 79. Hospital Universitari Son Espases, edifici S, 07120 Palma de Mallorca, Spain
| | - Luis Javier Molero-Ballester
- Hospital Manacor, Ctra Manacor-Alcudia s/n, 07500 Manacor (Mallorca), Spain; (L.J.M.-B.); (I.F.-F.); (C.M.-M.); (L.M.-M.)
| | - Ismael Fernandez-Fernandez
- Hospital Manacor, Ctra Manacor-Alcudia s/n, 07500 Manacor (Mallorca), Spain; (L.J.M.-B.); (I.F.-F.); (C.M.-M.); (L.M.-M.)
| | - Catalina Matamalas-Massanet
- Hospital Manacor, Ctra Manacor-Alcudia s/n, 07500 Manacor (Mallorca), Spain; (L.J.M.-B.); (I.F.-F.); (C.M.-M.); (L.M.-M.)
| | - Luis Moreno-Mejias
- Hospital Manacor, Ctra Manacor-Alcudia s/n, 07500 Manacor (Mallorca), Spain; (L.J.M.-B.); (I.F.-F.); (C.M.-M.); (L.M.-M.)
| | - Ian Blanco-Mavillard
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Ctra Palma-Valldemossa km 7.5, 07121 Palma Mallorca, Spain; (J.E.d.P.-G.); (I.B.-M.); (C.P.-L.)
- Balearic Islands Health Research Institute (IdISBa), Ctra Valldemossa, 79. Hospital Universitari Son Espases, edifici S, 07120 Palma de Mallorca, Spain
- Hospital Manacor, Ctra Manacor-Alcudia s/n, 07500 Manacor (Mallorca), Spain; (L.J.M.-B.); (I.F.-F.); (C.M.-M.); (L.M.-M.)
| | - Ana Belén Moya-Suarez
- Costa del Sol Hospital, Endoscopy & digestive medicine unit. Autovia A-7, Km. 187, 29603 Marbella, Spain;
- Instituto de Investigación Sanitaria de Málaga (IBIMA), Universidad de Málaga, C/ Arquitecto Francisco Peñalosa, 3, 29071 Málaga, Spain;
| | - Celia Personat-Labrador
- Department of Nursing and Physiotherapy, University of the Balearic Islands (UIB), Ctra Palma-Valldemossa km 7.5, 07121 Palma Mallorca, Spain; (J.E.d.P.-G.); (I.B.-M.); (C.P.-L.)
| | - José Miguel Morales-Asencio
- Instituto de Investigación Sanitaria de Málaga (IBIMA), Universidad de Málaga, C/ Arquitecto Francisco Peñalosa, 3, 29071 Málaga, Spain;
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Archer-Jones A, Sweeny A, Schults JA, Rickard CM, Johnson L, Gunter A, Watkins S. Evaluating an ultrasound-guided peripheral intravenous cannulation training program for emergency clinicians: An Australian perspective. Australas Emerg Care 2020; 23:151-156. [PMID: 31926958 DOI: 10.1016/j.auec.2019.12.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 12/04/2019] [Accepted: 12/23/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The primary objective of this study was to identify the proportion of clinicians using ultrasound guidance (USG) to insert peripheral intravenous cannulas (PIVCs) in the emergency department (ED) following attendance at a hospital-based USG PIVC training program. METHODS Over 12-months, USG cannulation training sessions were offered to nurses and doctors competent in standard PIVC insertion (landmark technique), working in the ED. Surveys pre and post-training captured participants' self-reported confidence with cannulation and USG cannulation using a 5-point Likert scale. Supplemental data from observation periods before and after the trainings assessed departmental cannulation practices overall. Data were analysed using descriptive statistics and associations analysed using chi-square tests. RESULTS Overall, 195 participants attended training; 58% completed follow-up surveys. Forty-three percent reported using USG cannulation the following month. The median confidence score amongst workshop participants increased from 1 to 3 (p<.001). Post-implementation, use of USG cannulation increased from 0.7% to 6.0% post-training (p<.001), although the overall number of attempts at PIVC placement did not change. CONCLUSIONS USG cannulation training increased this practice in the short-term. However, no significant difference in the number of attempts was observed. Further investigation in controlled settings is needed to inform the widespread implementation of USG cannulation training packages.
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Affiliation(s)
- Amy Archer-Jones
- Gold Coast Hospital and Health Service, Emergency Department, Southport, QLD, Australia
| | - Amy Sweeny
- Gold Coast Hospital and Health Service, Emergency Department, Southport, QLD, Australia; Griffith University School of Medicine, Gold Coast, Queensland, Australia.
| | - Jessica A Schults
- Alliance for Vascular Access Teaching and Research Group (AVATAR), Menzies Health Institute Queensland, Griffith University, Queensland, Australia; School of Nursing and Midwifery, Griffith University, Queensland, Australia; Department of Anaesthesia and Pain Management, Queensland Children's Hospital, Queensland, Australia
| | - Claire M Rickard
- Alliance for Vascular Access Teaching and Research Group (AVATAR), Menzies Health Institute Queensland, Griffith University, Queensland, Australia; School of Nursing and Midwifery, Griffith University, Queensland, Australia
| | - Laura Johnson
- Griffith University School of Medicine, Gold Coast, Queensland, Australia
| | - Ashleigh Gunter
- Gold Coast Hospital and Health Service, Emergency Department, Southport, QLD, Australia
| | - Stuart Watkins
- Gold Coast Hospital and Health Service, Emergency Department, Southport, QLD, Australia
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