Comparing successful insertions, dwell time, reinsertions and the costs of supplies between integrated and simple short peripheral catheters

Abstract

Background: Along with the challenges to strengthen patient safety in the use of short peripheral catheters (SPCs), various studies have been conducted in the past to explore differences between two main types of SPCs—integrated SPC (ISPC) and simple SPC (SSPC) in terms of clinical performance. The accumulated evidence from the literature lean toward the benefits of ISPC use in preventing complications leading to longer dwell time and more economical savings than SSPC use. The study aimed to compare ISPC and SSPC in terms of first-attempt successful insertions, number of attempts before successful insertion, perceived ease of insertion, dwell time, reinsertion rate, reasons for removal, and costs of supplies used for the insertions. Furthermore, it aimed to verify whether the previous results of referenced work in the use of ISPC were similar, and its use provided more foreseeable benefit for patient safety and cost-efficiency. Methods: This quasi-experimental study was conducted in a 650-bed tertiary academic medical center in the Philippines. Eligible participants were adult patients who were required SPC for at least 72 h by the physician. Using inferential statistics, comparisons were done among adult patients with integrated ( n = 350) and simple ( n = 350) SPC. Comparisons were also made according to insertion site and gauge of SPC. Results: The successful first-attempt insertions did not vary significantly at around 80% in both groups ( p = 0.428). No significant differences were found in terms of attempts before successful insertion ( p = 0.677), dwell time ( p = 0.144), reinsertions ( p = 0.934), and reasons for removal ( p = 0.424). Meanwhile, comparable differences were noted in terms of perceived ease of insertion ( p < 0.001) and cost of supplies used during the insertions ( p < 0.001). Conclusion: ISPCs can yield the same results with that of SSPCs while being easier to use and less costly.

Factors affecting the dwell times of peripheral intravenous catheters inserted by traditional vs. ultrasound-guided methods

“…The dwell time similarities or differences may have resulted from protocols that escalate the needed PIVC insertion from a novice to an expert (I.V. specialist or infusion team) and multiple attempts to insert the PIVC 13. A finely crafted protocol can decrease the number of attempts between the first PIVC attempt and expert insertion, thus maximizing patient comfort and PIVC dwell time.…”

“…The researchers of each study extracted postpatient discharge data from hospital electronic health records and calculated the median catheter dwell times for both traditional PIVCs and USGPIVCs. Two studies3,15 used the USGPIVC insertion; three used the traditional method 6,13,17. In most studies, traditional short PIVCs were utilized.…”

“…The Donabedian model was used to guide this review because of its relationship to quality improvement outcomes such that intervention quality can be measured by examining structures and processes leading to outcomes. 11 The Donabedian model considers the interaction between a patient and clinician who is delivering care, the state of healthcare at the time of analysis, the values of healthcare broadly, and ethics of healthcare practice. 12…”

“…This research should include long PIVC innovations and VADs that require guidewires. The most recent research points to the superiority of long PIVCs with guidewires, but these alternative VADs are currently costly,13 with one device costing up to $231 per catheter 18. Other modalities could be researched and developed that help to bring down the costs while providing longer dwell times.…”