The impact of the difficult vascular access, fear, and anxiety level in children on the success of first-time phlebotomy

Gerçeker, Gülçin Özalp; Ayar, Dıjle; Özdemir, Emine Zahide; Bektaş, Murat

doi:10.1177/1129729818765598

Cited by 19 publications

(20 citation statements)

References 31 publications

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“…In a paediatric hospital study, difficult vascular access and assessed Difficult Intravenous Access scores were found to be negatively correlated (p < 0.001 for both; n = 155) with firstattempt (on the day) venipuncture success among 4-10 year-old inpatients [50]. In findings similar to our own, this study noted that the major predictors of failure were the child's fear, self-reported anxiety before venipuncture, and difficult vascular access.…”

Section: Milky Way Study After Initial And/or Final Clinicssupporting

confidence: 73%

“…Although the use of topical anaesthetic appeared to reduce parent anxiety prior to blood collection, the 60-minute activation time seemed to heighten anxiety, and, potentially, anxiety-related pain [19] in the children. In previous research, fear and anxiety in children before venipuncture in the hospital setting was negatively correlated (p = 0.048; n = 155) with phlebotomy success [50].…”

Section: Parenting Behaviours Needle Fear and Reach Adherencementioning

confidence: 79%

“…For comparison with reported 'first attempt' success, or a successful initial venous access on the day, we achieved rates of 70.8% at baseline and 65.2% at the final clinic, after removal of one participant per clinic who achieved a successful venous access via the second arm attempted, and two participants per clinic who achieved success at a follow-up appointment. On this basis, tertiary hospital phlebotomists achieved 'first attempt' success rates of 81.9% with Turkish inpatients aged 4-10 years (mean 7.2 ± 2.2 years; n = 155) [50]. In a Netherlands tertiary paediatric hospital, successful inner elbow venous access insertions, including cannulation, were reported for 78.0% of 3-11 year-olds in the operating theatre (n = 534), and for 76.9% in the outpatient unit (n = 91) [56].…”

Section: Milky Way Study After Initial And/or Final Clinicsmentioning

confidence: 97%

“…However, this finding was for 3-11 year-old children in the operating theatre, where phlebotomy could be performed by a range of healthcare professionals, but not for those in outpatient care [56]. Additionally, duration of the most recent previous venipuncture procedure was found to adversely affect the success of subsequent blood draws [50]; this factor may have contributed towards our lower success rates at the final blood draws, by which time all compliant study children had attempted at least one previous blood test.…”

Section: Milky Way Study After Initial And/or Final Clinicsmentioning

confidence: 97%

“…The third clinic, held after three months of dairy intervention, incorporated all previous assessments. As per baseline procedures, we sent text and email reminders to help prepare the child and their family, and reviewed the day's procedures at the start of the clinic [50], using the pictorial schedule shown in…”

Section: Bodpod Body Composition Assessmentmentioning

confidence: 99%

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Using a Respectful Approach to Child-centred Healthcare (ReACH) in a paediatric clinical trial: A feasibility study

et al. 2020

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Background There is a growing momentum in paediatric ethics to develop respectful research and healthcare protocols. We developed, tested and refined our ‘Respectful Approach to Child-centred Healthcare’ (ReACH), to underpin respectful participant interactions in a clinical trial. Objective To determine whether a ReACH-based approach is acceptable to children and parents, and effective in obtaining compliance with common healthcare assessments in a clinical trial of healthy 4-6-year-old children. Methods ReACH-based child assessments were evaluated at two baseline clinics and one post-intervention, using mixed methods. Children (n = 49; 46.9% female; mean age = 5.24±0.88 years at baseline) and their parents provided independent evaluation, via customised 5-point Likert scales and qualitative feedback. A dedicated child researcher evaluated adherence to the study ReACH principles. Results Children achieved compliance rates of 95% for body composition (BodPod) assessments; 89% for blood pressure measurements, and 92% (baseline) and 87% (post-intervention) for blood draws. Adherence to ReACH principles during clinic visits was positively associated with child compliance, significantly for baseline BodPod (p = 0.002) and blood test (p = 0.009) clinics. Satisfaction with BodPod protocols was positively associated with compliance, for children at baseline (p = 0.029) and for parents post-intervention (p <0.001). Parents rated the study itself very highly, with 91.7% satisfied at baseline and 100% post-intervention. Qualitative feedback reflected an enjoyable study experience for both parents and children. Conclusions Adherence to our emerging ReACH approach was associated with high child compliance rates for common healthcare assessments, although no causality can be inferred at this preliminary stage of development. Participants expressed satisfaction with all aspects of the study. Our use of child-centred methods throughout a research intervention appears feasible and acceptable to children and their parents.

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Section: Milky Way Study After Initial And/or Final Clinicssupporting

confidence: 73%

Section: Parenting Behaviours Needle Fear and Reach Adherencementioning

confidence: 79%

Section: Milky Way Study After Initial And/or Final Clinicsmentioning

confidence: 97%

Section: Milky Way Study After Initial And/or Final Clinicsmentioning

confidence: 97%

Section: Bodpod Body Composition Assessmentmentioning

confidence: 99%

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Using a Respectful Approach to Child-centred Healthcare (ReACH) in a paediatric clinical trial: A feasibility study

et al. 2020

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“Passive or interactive virtual reality? The effectiveness for pain and anxiety reduction in pediatric patients”

et al. 2022

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Invasive techniques such as venipuncture are painful procedures causing stress and anxiety, both in pediatric patients and in their carers. For this reason, efforts are being made to develop mitigating strategies for the patient’s pain and anxiety during the performance. To analyze and evaluate the effectiveness of the use of Virtual Reality distraction techniques as a measure of pain and anxiety reduction in pediatric patients and their parents. In addition, the effects of two modes of Virtual Reality (passive vs. interactive) were compared. A quasi-experimental study was carried out in the pediatric emergency department of a tertiary referral hospital in north Spain. The participants were children who underwent venipuncture for blood extraction and vascular cannulation. From the 124 patients, 51.6% (n = 64) were girls and 48.4% (n = 60) were boys (p = 0.574). The mean age was 8.4 years (SD: 4.1). The mean level of pain experienced was 2.33 (SD: 0.76) in the interactive VR group (n = 88) versus 2.67 (SD: 1.35) in patients with passive VR (n = 36) (p = 0.008); being the presence of anxiety in 27.3% (n = 24) of the cases treated with interactive Virtual Reality and in 88.9% (n = 32) of the patients with passive Virtual Reality (p = 0.000). The virtual reality is an effective method to reduce pain and anxiety levels in pediatric patients, with the effectiveness of interactive virtual reality and its use in the population aged 7–15 years being greater.

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The effect of the closed intravenous catheter system on first insertion success, indwelling time, and complications in pediatric hematology and oncology patients: A randomized controlled study

Özalp Gerçeker,

Yıldırım,

Önal

et al. 2023

European Journal of Oncology Nursing

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The impact of the difficult vascular access, fear, and anxiety level in children on the success of first-time phlebotomy

Abstract: Child's fear, anxiety before phlebotomy, and difficult vascular access affects the first-time phlebotomy success.

Cited by 19 publications

References 31 publications

Using a Respectful Approach to Child-centred Healthcare (ReACH) in a paediatric clinical trial: A feasibility study

Using a Respectful Approach to Child-centred Healthcare (ReACH) in a paediatric clinical trial: A feasibility study

“Passive or interactive virtual reality? The effectiveness for pain and anxiety reduction in pediatric patients”

The effect of the closed intravenous catheter system on first insertion success, indwelling time, and complications in pediatric hematology and oncology patients: A randomized controlled study

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