Dwell time of peripheral intravenous catheter and its association with the risk of infiltration, phlebitis, and pain in pediatric patients

2012 ◽  
Vol 13 (4) ◽  
pp. S6 ◽  
Author(s):  
C. Chan ◽  
S. Leung ◽  
S. Ho ◽  
K. Choi ◽  
W. Ip
Keyword(s):  
Dwell Time ◽  
Pediatric Patients ◽  
Intravenous Catheter ◽  
Peripheral Intravenous Catheter

scholarly journals Current practices of peripheral intravenous catheter fixation in pediatric patients and factors influencing pediatric nurses’ knowledge, attitude and practice concerning peripheral intravenous catheter fixation: a cross-sectional study

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Li-Sha Huang ◽  
Yan Huang ◽  
Juan Hu
Keyword(s):  
Pediatric Patients ◽  
Pass Rate ◽  
Attitude Score ◽  
Multivariate Linear Regression Analysis ◽  
Pediatric Nurses ◽  
Intravenous Catheter ◽  
Attitude And Practice ◽  
Peripheral Intravenous Catheter ◽  
Knowledge Attitude And Practice ◽  
Nurses Knowledge

Abstract Background Peripheral intravenous catheters (PIVCs) are the most widely used intravenous treatment tools for hospitalized patients. Compared to adult patients, PIVC fixation issues are more likely to occur in pediatric patients and can be more complex. However, research on PIVC fixation in pediatric patients is rare. This study aimed to investigate the pass rate for PIVC fixation in pediatric patients and the factors that influence pediatric nurses’ knowledge, attitude, and practice (KAP) concerning PIVC fixation. Methods An on-site investigation using a self-designed PIVC fixation standard inspection checklist for first insertion and routine maintenance in pediatric patients and a follow-up questionnaire survey investigating pediatric nurses’ KAP concerning PIVC fixation was conducted in a hospital in China between November 1 and December 31, 2019. Data were analyzed using SPSS 21.0. Results The pass rate for PIVC fixation in pediatric patients was 52.02%. The pediatric nurses’ knowledge, attitude and practice scores on PIVC fixation were 7.2 ± 1.36, 28.03 ± 2.42, and 31.73 ± 2.94, respectively. The multivariate linear regression analysis results show that department (where nurses are working in) and job position are the factors that influence knowledge score (B > 0, P < 0.05); department is also a factor that influences attitude score (B > 0, P < 0.05); and department and nursing hierarchy are the factors that influence practice score (B > 0, P < 0.05). Conclusion PIVC fixation in pediatric patients is affected by multiple factors. The level of pediatric nurses’ KAP on PIVC fixation needs to be improved. It is suggested that guidelines for PIVC fixation in pediatric patients be formulated and that training on PIVC fixation in pediatric patients be provided for pediatric nurses in an effort to raise the pass rate in terms of PIVC fixation in pediatric patients.

Nurse performed peripheral intravenous catheter first time insertion success in pediatric patients in Bhutan: An observational study

2018 ◽  
Vol 20 (2) ◽  
pp. 184-189 ◽  
Author(s):  
Jigme Choden ◽  
Peter J Carr ◽  
Aleisha R Brock ◽  
Adrian Esterman
Keyword(s):  
Skin Color ◽  
Pediatric Patients ◽  
Linear Models ◽  
National Sample ◽  
Intravenous Catheter ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Peripheral Intravenous Catheter ◽  
The Impact ◽  
First Time

Introduction: Peripheral intravenous catheter insertion is a clinical procedure commonly performed by nurses for pediatric patients in Bhutan. This study describes peripheral intravenous catheter first attempt success and factors associated with such insertions. Methods: A cross-sectional survey was conducted from October 2016 to March 2017, comprised of a national sample of the Bhutan pediatric patient population (0–12 years). We collected data on peripheral intravenous catheter first time insertion success rate of admitted pediatric patients, to identify predictors of a successful first time attempt. Clustered log binomial generalized linear models were used to obtain the prevalence of first time attempt success and predictors of success. Results: The prevalence rate of successful first time attempt adjusted for clustering was 64% (95% confidence interval: 51%–80%). Predictors of a successful first time attempt were older patient age, lighter skin color, the vein being visible with a tourniquet, and the left hand being used for insertion. A transilluminator was used in 52 patients, and the peripheral intravenous catheter was eventually successfully placed in 82% of the patients. Discussion: Our first time successful cannulation rate is substantially lower than that found in similar studies in other countries. Considering the impact a peripheral intravenous catheter has on patients’ clinical outcomes and cost implications, reducing the number of failed attempts should be of high importance. Better education and simulation, combined with the adoption of vessel locating technology, are required to improve insertion practice in Bhutan. This could lead to greater efficiency of the health facilities in Bhutan.

Effectiveness of transparent film dressing for peripheral intravenous catheter

2020 ◽  
pp. 112972982092723
Author(s):  
Selma Atay ◽  
Fatma Yilmaz Kurt
Keyword(s):  
Dwell Time ◽  
Venous Catheter ◽  
University Hospital ◽  
Control Group ◽  
Transparent Film ◽  
Patient Identification ◽  
Intravenous Catheter ◽  
Chi Square ◽  
Peripheral Venous Catheter ◽  
Peripheral Intravenous Catheter

Background: The intravenous applications are the most common type of such interventions. It is underlined that in cases where the peripheral intravenous catheter is not properly secured in place, even a minor movement inside the vein would result in injury of vein. Objective: The insertion of peripheral intravenous catheter is a common practice. This is a randomized controlled prospective study aiming at investigating the effectiveness of use of transparent film dressing for peripheral intravenous catheter. Methods: The universe of this study included inpatients in the Internal Diseases clinic of a University Hospital, and the sample included a total of 110 peripheral intravenous catheters that were calculated by power analysis. The patient identification form, the peripheral venous catheter and treatment information form, and the visual infusion phlebitis identification scale were used to collect data. The forms were completed by the investigators on the basis of daily observations. The data were assessed by the percentage, chi-square test, and logistic regression analysis via the software SPSS 20.00. Results: The individuals in the study group and the control group included in the sample are comparable in terms of gender, having/not having a chronic disease, the site of peripheral intravenous catheter, use of antibiotics, intravenous fluid therapy, and mean age. There were no statistically significant differences between the groups. There was a significant relationship between the dwell time for the catheter and development of any complications and the groups. Conclusion: The use of transparent film dressing for insertion of peripheral intravenous catheter can be recommended as it increases the dwell time for the catheter and reduces incidence of complications.

The AccuCath Intravenous Catheter System With Retractable Coiled Tip Guidewire and Conventional Peripheral Intravenous Catheters: A Prospective, Randomized, Controlled Comparison

2014 ◽  
Vol 19 (2) ◽  
pp. 94-102 ◽  
Author(s):  
Bette K. Idemoto ◽  
James R. Rowbottom ◽  
James D. Reynolds ◽  
Ronald L. Hickman
Keyword(s):  
Patient Satisfaction ◽  
User Satisfaction ◽  
Dwell Time ◽  
Adult Patients ◽  
Background Current ◽  
Intravenous Catheter ◽  
Randomized Controlled ◽  
Catheter System ◽  
Peripheral Intravenous Catheter ◽  
Intravenous Catheters

Abstract Background: Current peripheral intravenous catheter (PIV) first attempt success averages 47%, complications 47%, and dwell time 44 hours. Multiple intravenous (IV) access lines requiring replacement during each admission result in poor satisfaction and unnecessary costs. With 2011 Infusion Nursing Society standards allowing IV lines to dwell until complication, there is incentive to explore improvement opportunities. Purpose: A new, proprietary coiled tip guidewire PIV was compared with conventional IV catheters in adult patients. The experimental IV catheter was projected to have a higher rate of successful placement on first attempt, fewer complications, longer dwell times, higher completion of therapy, higher user satisfaction, and lower overall costs than conventional catheters. Methods: Adult patients requiring nonemergent IV catheters provided consent and were enrolled and randomized. The study, conducted over 4 months, included 248 patients (experimental IV group n =123, conventional IV group n =125). Results: Experimental IV first attempt success was 89% compared with 47% for the conventional catheter. Fifty percent of conventional IV placements required a second attempt. Experimental IV complications occurred 8% of the time and complications occurred with the conventional catheter 52% of the time. Completion of therapy was 89% with the experimental IV versus 34% with the conventional IV (P &lt; .001). Dwell time improved with the experimental IV (mean 4.4 days [105 hours] vs conventional IV at 1.5 days [35 hours]) (P &lt; .001). Overall patient satisfaction using a 5-point Likert scale scored an average of 4.5 with the experimental IV compared with the conventional IV, which scored 3. Conclusions: A new, proprietary coiled tip guidewire-delivered PIV demonstrated clear superiority over the conventional catheter in our study. Clinical outcome results showed statistically significant improvements in first attempt success, complications, completion of therapy, dwell time, and overall patient satisfaction.

scholarly journals Risk Factors for Phlebitis in Patients with Peripheral Intravenous Catheters

2019 ◽  
Vol 12 (1) ◽  
pp. 41
Author(s):  
Fengmei Tan ◽  
Silin Zheng ◽  
Hongyan Wu ◽  
Lixia Nie ◽  
Wenhua Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Dwell Time ◽  
Insertion Site ◽  
Outer Diameter ◽  
Hypertonic Solution ◽  
Intravenous Catheter ◽  
Infusion Solution ◽  
Peripheral Intravenous Catheter ◽  
Insertion Sites ◽  
Intravenous Catheters

Introduction: The study investigated the risk factors of phlebitis associated with infusion by peripheral intravenous catheter (PIVC). Methodology: Hospitalized adults (n = 506) were placed with PIVCs by trained nurses. Rates of phlebitis were noted according to PIVC gauge, insertion site, and dwell time; and type and volume of infusion solution. Results: The development of phlebitis appeared to be significantly associated with the size of the outer diameter of the PIVC. The rate of phlebitis among patients given a hypertonic infusion solution was significantly higher; and also associated with infusion volume. There was no difference in phlebitis development among insertion sites, and dwell times among these sites were comparable. Conclusion: The risk of phlebitis increased with the PIVC size and volume of infusion solution, and use of a hypertonic solution. The recognition of risk factors and standardized intervention may reduce the occurrence of phlebitis associated with PIVC use.

Ultrasound-guided placement of peripherally inserted intravenous catheters increase catheter dwell time in children

2020 ◽  
pp. 112972982092982
Author(s):  
James Thomas Cottrell ◽  
Todd Chang ◽  
Jennifer Baird ◽  
Joanna Barreras ◽  
Marsha A Elkhunovich
Keyword(s):  
Dwell Time ◽  
Hospitalized Children ◽  
Ultrasound Guided ◽  
Intravenous Catheter ◽  
Free Standing ◽  
Probability Of Survival ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Peripheral Intravenous Catheter ◽  
Intravenous Catheters

Objective: To compare the dwell times of ultrasound-guided and non-ultrasound-guided short peripheral intravenous catheters in hospitalized children. Methods: This was a retrospective analysis of data from 256 ultrasound-guided and 287 traditional peripheral intravenous catheters placed in hospitalized children between 1 September2016 and 31 October 2016 at a free-standing children’s hospital with a 10-member vascular access team. A two-sample independent t test and Kaplan–Meier estimator were used to assess differences in dwell times between the ultrasound-guided peripheral intravenous catheters and non-ultrasound-guided peripheral intravenous catheters. Child age, peripheral intravenous catheter location, and subjective difficulty of placement were also analyzed. Results: There was a significant difference in mean hours of dwell time for ultrasound-guided versus non-ultrasound-guided peripheral intravenous catheters (96.06 vs 59.39, p < 0.001). Mean increase in dwell time was 36.68 h (95% CI: [24.14–49.22]). Median dwell times (50% probability of survival) for ultrasound-guided and non-ultrasound-guided peripheral intravenous catheters were 118 h (95% CI: [95–137]) and 71 h (95% CI: [61–79]), respectively. None of the additional covariates were significant predictors of dwell time. Conclusion: Peripheral intravenous catheters placed using ultrasound-guided methods had a significantly longer dwell time than those placed using non-ultrasound-guided methods in a cohort of hospitalized pediatric patients. This is in line with the findings in the adult literature and may suggest a need to increase the use of ultrasound-guided method for peripheral intravenous catheter placement in pediatric practice.

scholarly journals Reaching One Peripheral Intravenous Catheter (PIVC) Per Patient Visit With Lean Multimodal Strategy: the PIV5Rights™ Bundle

2019 ◽  
Vol 24 (3) ◽  
pp. 31-43 ◽  
Author(s):  
Lee Steere ◽  
Cheryl Ficara ◽  
Michael Davis ◽  
Nancy Moureau
Keyword(s):  
Vascular Access ◽  
Dwell Time ◽  
Best Practice ◽  
Current Practice ◽  
Infusion Therapy ◽  
Intravenous Catheter ◽  
Peripheral Intravenous Catheter ◽  
Group 2 ◽  
The Right ◽  
Group 1

Highlights Lean leadership for process improvement. Prospective comparator multimodal design study. Vascular access specialty team (VAST group 2) versus generalist nursing model (group 1). First stick success of 96%. Statistically significant improvement in dwell time with VAST versus generalist nursing model (89% versus 15% lasting until end of therapy). Projected 2.9 million in savings annually. Peripheral intravenous catheter team centralized proposal to Chief Nursing Officer (CNO) with acceptance based on outcomes. Reduction in cost per bed per year using a vascular access specialty team of $3376. Abstract Background: Peripheral intravenous catheter (PIVC) sales per year exceed that of the number of people in the United States (US), 350 million. With only 37 million US hospital patient admissions per year, these data indicate an average usage of 10 PIVCs per patient admission, suggesting a very high failure, very low success rate, and excess cost associated with PIVC insertions. Patients often complain of multiple catheter insertion attempts, and published data reveal up to 53% of PIVCs fail before therapy ends. Methods: Hartford Hospital (Hartford, CT) conducted a prospective comparator single-center clinical superiority design study to determine the impact of bundled practices including device insertions using vascular access specialty team (VAST) intravenous trained nurses versus current practice. The study used a 5 step multimodal best practice intervention strategy designated as the PIV5Rights Bundle with an aim to determine if the intervention outcomes and dwell time improved over current PIVC practices. The study group applied a Lean health care standard work process with a Six Sigma design, define, measure, analyze, improve, control approach that included VAST PIVC dwell time, complications, and economic impact compared with current state general nursing practice. Results: Outcomes of the PIV5Rights Bundle in Group 2 (experimental) using a trained vascular access nursing team for insertion and management achieved a statistically significant result of 89% of catheters achieving end of therapy with a cost saving per bed of $3376 ($1405 versus $4781) per year as compared to standard practice (Group 1; control). Results of Group 1 reflected PIVC dwell time to end of treatment in only 15% of catheters. Prestudy catheter consumption analysis was 4.4 catheters per patient hospital admissions, reflecting waste within labor and supply costs for PIVC insertion and usage. Peripheral intravenous catheter retrospective audits for current practice demonstrated more than 50% catheters failed within the first 24 hours. This application of Lean methodology by Hartford Hospital with infusion therapy resulted in a projected $2.9 million annual savings of $3376 per bed per year for house-wide application. Conclusions: Implementation of the PIV5Rights™ Bundle with a dedicated VAST proved to be a successful model, both from a patient and financial perspective. The journey to nursing excellence included identification of core measures and best practice evidence for PIVC placements as a procedure that affects nearly every patient entering a hospital. By centralizing ownership of vascular access with the team for insertion, management, and securement, the PIV Five Rights is the right approach to achieve the right results in transformation of hospital infusion therapy practices. Bundled approaches have often been used for central catheter infection reduction. This is the first study the authors have identified focusing on 1 PIVC per patient visit as a result of an evidence-based bundle and VAST.

Sign in / Sign up

Export Citation Format

Share Document