Peripheral intravenous catheter failure: A secondary analysis of risks from 11,830 catheters

Marsh, Nicole; Larsen, Emily; Takashima, Mari; Kleidon, Tricia; Keogh, Samantha; Ullman, Amanda; Mihala, Gabor; Chopra, Vineet; Rickard, Claire M

doi:10.1016/j.ijnurstu.2021.104095

Cited by 67 publications

(80 citation statements)

References 59 publications

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“…Additionally, there was considerable heterogeneity across the surveyed departments in terms of numbers of routine room visits avoided and numbers of end of infusion detected early enough to avoid cannula occlusion, but no evidence of heterogeneity in terms of reported time freed per nurse shift. This variation is quite natural, given the recent Australian real-world evidence [ 24 ], where the proportion of females or the use of IV antibiotics significantly increased the risk for phlebitis, infiltration or occlusion and failure, while older age significantly decreased the risk of phlebitis and failure. Vascular access team's catheters were significantly less likely to dislodge, and all-cause failure was significantly increased by wrist or hand, antecubital fossa peripheral IV, and 22- or 24-gauge catheters [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…This variation is quite natural, given the recent Australian real-world evidence [ 24 ], where the proportion of females or the use of IV antibiotics significantly increased the risk for phlebitis, infiltration or occlusion and failure, while older age significantly decreased the risk of phlebitis and failure. Vascular access team's catheters were significantly less likely to dislodge, and all-cause failure was significantly increased by wrist or hand, antecubital fossa peripheral IV, and 22- or 24-gauge catheters [ 24 ]. We weighted the respondents inversely proportional to the number of respondents in the ward, such that each ward was allocated the same weight in the analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Using year 2021 euros, the resources associated with a routine visit avoided to an isolation room were set to €4.52 (protective coat, mask, and nitrile gloves [ 23 ]), and an early enough detection of risk of blockage before, e.g. cannula occlusion was assigned a resource cost saving of €2.00 for the cannula, which are both likely underestimates [ 24 ]. Prevention or early detection of other problems was conservatively assumed to have no economic value.…”

Section: Methodsmentioning

confidence: 99%

“…In addition, in a scenario analysis, we modified the cost savings associated with early enough detection of risk of blockage to the most affordable official Finnish hospital tariff for an anaesthesiologist placing a new venous cannula (Kainuu hospital district price list 2021: €216.00), and assumed that this early detection prevents a new cannulation in 23.4% of cases noted with the Monidor solution (that is, 23.4% was the risk of occlusion or infiltration observed in a recent sample of 11,830 catheters [ 24 ]). The material cost of €2.00 was excluded from the cannulas set by anaesthesiologist to avoid double counting.…”

Section: Methodsmentioning

confidence: 99%

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Advantages in Management and Remote Monitoring of Intravenous Therapy: Exploratory Survey and Economic Evaluation of Gravity-Based Infusions in Finland

Puolitaival¹,

Savola²,

Tuomainen³

et al. 2022

Adv Ther

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Introduction Intravenous infusion therapy is a common and challenging invasive treatment procedure in hospital wards. Administration mistakes can have serious, even life-threatening, consequences. The Monidor solution was developed to help nurses administer gravity-based infusions and monitor them remotely, to avoid complications and reduce workload. Its real-world effects and economic consequences were unknown. Methods An exploratory survey was carried out to estimate the potential impact of the Monidor solution on events and nurse time use. At the end of their shift, nurses estimated effects in terms of routine room visits avoided, prevention of complications, and impact on nurse time requirements. Linear regression was applied to estimate predictors of time freed. A health economic model was developed to evaluate economic consequences and to calculate the net return on investment for a hypothetical hospital ward. A 1-month time horizon was used, and discounting was not applied. Results A total of 216 responses were obtained from 6 Finnish hospitals, from a total of 15 wards, and 56.3% of nurses found that the Monidor solution freed nurse time, while < 3.5% experienced additional time requirements. Per nurse shift, the Monidor solution avoided on average 2.064 routine room visits, helped detect end of infusion 1.340 times, and led to 5.045 min of time freed. One routine visit avoided was associated with 2.453 min of time freed in the linear regression. In the conservative setting, the freed monthly capacity in the hypothetical ward amounted to €1270.90 per month (year 2021), yielding a return on investment of 2.63. Uncertainty of linear regression coefficient values was identified as a driver of uncertainty in sensitivity analysis, with return on investment ranging from 1.55 to 3.71. Conclusions The study demonstrated that management and remote monitoring with the Monidor solution frees nurse time and reduces routine activities associated with gravity-based intravenous infusions. These findings could be confirmed in a comparative empirical study. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-022-02093-6.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Advantages in Management and Remote Monitoring of Intravenous Therapy: Exploratory Survey and Economic Evaluation of Gravity-Based Infusions in Finland

Puolitaival¹,

Savola²,

Tuomainen³

et al. 2022

Adv Ther

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“…Each shift, the nurse should assess for device complications, prompting early identification and correction of issues, and if necessary, removal and insertion of a new device. Unfortunately, device-associated complications are common; up to two-thirds of PIVCs (Marsh et al, 2021;Marsh et al, 2018) and one-fourth of CVADs (Takashima et al, 2018) cease to function before treatment is complete, resulting in painful and time-consuming additional insertion procedures, which also increases hospital costs (Lim et al, 2019).…”

Section: Complication-free?mentioning

confidence: 99%

I-DECIDED® – A decision tool for assessment and management of invasive devices in the hospital setting

Ray‐Barruel¹

2021

Vasc Acc

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Indwelling medical devices, including vascular access and urinary catheters, pose a risk for infection, and therefore daily assessment and consideration of their continued need is a patient safety priority. The I-DECIDED® device assessment and decision tool is an evidence-based checklist, designed to improve the assessment, care, and timely removal of invasive devices in acute hospitalized patients. This paper explains each step of the tool, with rationale for inclusion.

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Novel Peripheral Intravenous Catheter Securement for Children and Catheter Failure Reduction

Charters,

Foster,

Lawton

et al. 2024

JAMA Pediatr

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ImportancePeripheral intravenous catheters (PIVCs) facilitate essential treatment. Failure of these essential devices is frequent and new securement strategies may reduce failure and improve patient outcomes.ObjectiveTo evaluate clinical effectiveness of novel PIVC securement technologies for children to reduce catheter failure.Design, Setting, and ParticipantsA 3-arm, parallel group, superiority randomized clinical trial was conducted at 2 regional Australian hospitals from February 5, 2020, to January 14, 2022. Children aged 6 months to 8 years who were anticipated to require admission with a PIVC for at least 24 hours of in hospital treatment were eligible. Data were analyzed from May 25, 2022, to February 20, 2024.InterventionsParticipants were randomly allocated in a 1:1:1 ratio to standard care, bordered polyurethane (Tegaderm [3M]), integrated securement dressing (SorbaView SHIELD [Medline]), and integrated securement dressing with tissue adhesive (Secureport IV). One catheter was studied per patient.Main Outcomes and MeasuresPrimary outcome was PIVC failure, defined as premature cessation of PIVC function for any reason prior to completion of planned treatment. Secondary outcomes were PIVC complications (any time dislodgement, occlusion, infiltration, partial dislodgement, extravasation, device leaking, phlebitis, pain), PIVC longevity, intervention acceptability (clinicians, participants, caregivers; 0-10 scale), and pain on removal (participants and caregivers; 0-10 scale relevant to age), adverse events, and health care costs.ResultsA total of 383 patients (51% female; median age 36 [25th-75th percentiles, 22-72] months) were randomized 134 to standard care, 118 to integrated securement dressing, and 131 to integrated securement dressing with tissue adhesive. PIVC failure was lowest in integrated securement dressing with tissue adhesive (15 [12%]; adjusted hazard ratio [aHR], 0.47; 95% CI, 0.26-0.84) compared with integrated securement dressing (24 [21%]; aHR, 0.78; 95% CI, 0.47-1.28) and standard care (43 [34%]). Direct costs were significantly lower for integrated securement dressing with tissue adhesive (median, Australian dollars [A$], 312 [A$1 is equal to $0.65 US dollars]; IQR, A$302-A$380) and integrated securement dressing (median, A$303; IQR, A$294-A$465) compared with standard care (median, A$341; IQR, A$297-A$592; P ≤ .002) when considering the economic burden related to failure of devices. PIVC longevity and intervention acceptability were similar across all groups.Conclusions and RelevanceIn this study, PIVCs secured with integrated securement dressings and tissue adhesive, in comparison with standard care, bordered polyurethane dressings, were associated with significantly reduced PIVC failure, for children admitted to hospital via the emergency department. Further research should focus on implementation in inpatient units where prolonged dwell and reliable intravenous access is most needed.Trial RegistrationAustralian New Zealand Clinical Trials Registry Identifier: ACTRN12619001026112

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Peripheral intravenous catheter failure: A secondary analysis of risks from 11,830 catheters

Cited by 67 publications

References 59 publications

Advantages in Management and Remote Monitoring of Intravenous Therapy: Exploratory Survey and Economic Evaluation of Gravity-Based Infusions in Finland

Advantages in Management and Remote Monitoring of Intravenous Therapy: Exploratory Survey and Economic Evaluation of Gravity-Based Infusions in Finland

I-DECIDED® – A decision tool for assessment and management of invasive devices in the hospital setting

Novel Peripheral Intravenous Catheter Securement for Children and Catheter Failure Reduction

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