Understanding consumer preference for vascular access safety and quality measurement: an international survey

Schults, Jessica; Paterson, Rebecca; Kleidon, Tricia; Cooke, Marie; Ullman, Amanda; McNeil, Keith; Chopra, Vineet; Charles, Karina; Ray‐Barruel, Gillian; Marsh, Nicole; Sullivan, Clair; Sturgess, David; Rickard, Claire M

doi:10.1071/ah21053

Cited by 9 publications

(7 citation statements)

References 38 publications

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“…Across all EHRs, 86% of internationally recommended quality surveillance items are collected, however, unlinked systems mean health jurisdictions are unable to utilize these systems to their maximum potential for catheter quality surveillance requirements. Importantly, patient reported experience measures were not captured across any EHR (e.g., can the patient identify the reason for the device; 14 ), a notable limitation of existing systems. Our findings confirm that despite the rapid digitalization of health care, many EHR systems are yet to reach their full potential to support hospital quality surveillance and proactive monitoring of IV catheter care.…”

Section: Discussionmentioning

confidence: 99%

“…The implementation of standardized IV catheter surveillance will be challenging, improving data linkage capabilities between all current systems will be costly but would increase the power to detect associations in clinical characteristics and risks. Further improved interoperability and item standardization will result in increased efficiencies which will facilitate easier, more reliable reporting and analysis of clinical and surveillance data ( 14 ). This information can be used to inform targeted catheter improvement programs, which will in turn improve patient outcomes and decrease healthcare utilization and costs.…”

Section: Discussionmentioning

confidence: 99%

“…Measurement of process, system, and outcome parameters related to IV catheters has been performed in hospitals using basic audit methods ( 12 ) with varied success for decades. This approach to quality surveillance is resource intensive and limits multijurisdictional benchmarking ( 13 ) and performance reporting ( 14 ) due to heterogeneity in items and case definitions ( 15 ). However, the reliability and validity of this data are becoming increasingly important with an increasing regulatory environment and persisting patient safety problems related to IV catheters.…”

Section: Introductionmentioning

confidence: 99%

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Mapping progress in intravascular catheter quality surveillance: An Australian case study of electronic medical record data linkage

et al. 2022

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Background and significanceIntravascular (IV) catheters are the most invasive medical device in healthcare. Localized priority-setting related to IV catheter quality surveillance is a key objective of recent healthcare reform in Australia. We sought to determine the plausibility of using electronic health record (EHR) data for catheter surveillance by mapping currently available data across state-wide platforms. This work has identified barriers and facilitators to a state-wide EHR surveillance initiative.Materials and methodsData variables were generated and mapped from routinely used EHR sources across Queensland, Australia through a systematic search of gray literature and expert consultation with clinical information specialists. EHR systems were eligible for inclusion if they collected data related to IV catheter insertion, care, or outcomes of hospitalized patients. Generated variables were mapped against international recommendations for IV catheter surveillance, with data linkage and data export capacity narratively summarized.ResultsWe identified five EHR systems, namely, iEMR, MetaVision ICU®, Multiprac, RiskMan, and the Nephrology Registry. Systems were used across jurisdictions and hospital wards. Data linkage was not evident across systems. Extraction processes for catheter data were not standardized, lacking clear and reliable extraction techniques. In combination, EHR systems collected 43/50 international variables recommended for catheter surveillance, however, individual systems collected a median of 24/50 (IQR 22, 30) variables. We did not identify integrated clinical analytic systems (incorporating machine learning) to support clinical decision making or for risk stratification (e.g., catheter-related infection).ConclusionCurrent data linkage across EHR systems limits the development of an IV catheter quality surveillance system to provide timely data related to catheter complications and harm. To facilitate reliable and timely surveillance of catheter outcomes using clinical informatics, substantial work is needed to overcome existing barriers and transform health surveillance.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mapping progress in intravascular catheter quality surveillance: An Australian case study of electronic medical record data linkage

et al. 2022

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“…The research nurse entered basic patient demographics and device data on enrollment and updated catheter use and management daily (Monday-Friday). Data collected were based on international recommendations for a vascular access minimum data set and consumer priorities . Data were collected using a standardized form and entered directly into the secure web-based data platform Research Electronic Data Capture (REDCap [Vanderbilt University]) …”

Section: Methodsmentioning

confidence: 99%

“…Data collected were based on international recommendations for a vascular access minimum data set 35 and consumer priorities. 36 Data were collected using a standardized form and entered directly into the secure web-based data platform Research Electronic Data Capture (REDCap [Vanderbilt University]). 37…”

Section: Data Collectionmentioning

confidence: 99%

Midline Compared With Peripheral Intravenous Catheters for Therapy of 4 Days or Longer in Pediatric Patients

Kleidon,

Gibson,

Cattanach

et al. 2023

JAMA Pediatr

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ImportancePeripheral intravenous catheters (PIVCs) frequently fail during treatment causing therapy interruption, pain, recatheterization, and additional health care costs. Midline catheters (MCs) may improve functional dwell time and reduce failure compared with traditional PIVCs.ObjectiveTo compare device failure of MCs with PIVCsDesign, Setting, and ParticipantsThis was a pragmatic, randomized clinical superiority trial with an embedded internal pilot study conducted from July 2020 to May 2022. The study took place in a quaternary pediatric hospital in Brisbane, Queensland, Australia. Inclusion criteria were patients aged 1 to 18 years requiring peripherally compatible intravenous therapy for 4 days or longer.InterventionsPatients were randomly assigned 1:1 to receive a PIVC or MC, stratified by age (≤5 years, &gt;5 years). One catheter was studied per patient.Main Outcomes and MeasuresThe primary outcome was all-cause device failure, defined as premature cessation of device function. Secondary outcomes included number of insertion attempts, insertion failure, pain (on insertion), procedural time, patient/parent satisfaction (with insertion), device dwell time, device complications during dwell time, additional vascular access devices required to complete treatment, clinician satisfaction (at removal), and health care costs.ResultsOf the 128 patients randomly assigned to study groups, 127 patients (median [IQR] age, 7 [2-13] years; 71 male [56%]) had a device inserted, with 65 (51.2%) in the PIVC group and 62 (48.8%) in the MC group. All patients were included in the intention-to-treat analysis. Device failure was lower in patients in the MC group (10 [16.1%]) compared with those in the PIVC group (30 [46.2%]; odds ratio [OR], 0.22; 95% CI, 0.10-0.52; P &lt;.001). MCs were associated with fewer insertion attempts (mean difference [MD], −0.3; 95% CI, −0.5 to 0; P = .04), increased dwell time (MD, 66.9 hours; 95% CI, 36.2-97.5 hours; P &lt;.001), and fewer patients required additional vascular access devices to complete treatment in the MC group (4 [6.5%]) and PIVC group (19 [29.2%]; OR, 0.17; 95% CI, 0.05-0.52; P = .002). Compared with PIVCs, use of MCs was associated with greater patient (9.0 vs 7.1 of 10; P = .002) and parent (9.1 vs 8.2 of 10; P = .02) satisfaction and lower health care costs (AUS −$151.67 [US −$101.13] per person; 95% credible interval, AUS −$171.45 to −$131.90 [US −$114.20 to −$87.95]).Conclusions and RelevanceFindings suggest that MC insertion for patients requiring peripherally compatible intravenous therapy for 4 days or longer should be prioritized to reduce the resource intensive, expensive, and burdensome sequelae of device failure.Trial RegistrationAustralia New Zealand Clinical Trials Registry, ACTRN12620000724976

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Dressings and securement devices to prevent complications for peripheral arterial catheters

Schults,

Reynolds,

Rickard

et al. 2024

Cochrane Database of Systematic Reviews

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Understanding consumer preference for vascular access safety and quality measurement: an international survey

Cited by 9 publications

References 38 publications

Mapping progress in intravascular catheter quality surveillance: An Australian case study of electronic medical record data linkage

Mapping progress in intravascular catheter quality surveillance: An Australian case study of electronic medical record data linkage

Midline Compared With Peripheral Intravenous Catheters for Therapy of 4 Days or Longer in Pediatric Patients

Dressings and securement devices to prevent complications for peripheral arterial catheters

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