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.

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 Peripheral Intravenous Catheter Insertion: The Nurse’s Manual

2020 ◽  
Vol 40 (5) ◽  
pp. 38-46
Author(s):  
Lauren Morata ◽  
Mark Bowers
Keyword(s):  
Acute Care ◽  
Venous Access ◽  
Catheter Placement ◽  
Ultrasound Guided ◽  
Intravenous Catheter ◽  
Peripheral Intravenous Catheter ◽  
Acute Care Nursing ◽  
Intravenous Catheters ◽  
Difficult Venous Access ◽  
Central Catheters

Peripheral intravenous catheter placement is a skill that is used daily in the hospital. However, many nurses face the challenge of cannulating increasingly complex and difficult-to-access vasculature. Although emergency department clinicians have been using ultrasound to facilitate this procedure for the last 18 years, ultrasound-guided peripheral intravenous catheter placement has not been as rapidly adopted in the critical and acute care nursing realms. Given the benefits of this procedure, including increased patient satisfaction and reduced use of central catheters, its use should be encouraged among all acute care clinicians. The aim of this article is to provide the bedside nurse with a basic understanding of the techniques involved in placing ultrasound-guided peripheral intravenous catheters in patients with difficult venous access.

Procedural competency for ultrasound-guided peripheral intravenous catheter insertion for nurses in a pediatric emergency department

2020 ◽  
pp. 112972982093713
Author(s):  
Carly Blick ◽  
Alexandra Vinograd ◽  
Jamie Chung ◽  
Elizabeth Nguyen ◽  
Mary Kate F Abbadessa ◽  
...  
Keyword(s):  
Emergency Department ◽  
Training Program ◽  
Success Rate ◽  
Training Period ◽  
Complication Rates ◽  
Initial Training ◽  
Ultrasound Guided ◽  
Intravenous Catheter ◽  
Peripheral Intravenous Catheter ◽  
Intravenous Catheters

Objectives: To evaluate if nurses can reliably perform ultrasound-guided peripheral intravenous catheter placement in children with a high success rate after an initial training period. A secondary aim was to analyze complication rates of ultrasound-guided peripheral intravenous catheters. Methods: A database recorded all ultrasound-guided peripheral intravenous catheter encounters in the emergency department from November 2013 to April 2019 including the emergency department nurse attempting placement, number of attempts, and whether it was successful. Patient electronic medical records were reviewed for the time of and reason for intravenous removal. The probabilities of first-attempt successful intravenous placement and complication at successive encounters after an initial training period were calculated. These probabilities were plotted versus encounter number to graph best-fit logarithmic regressions. Results: A total of 83 nurses completed a standardized training program in ultrasound-guided peripheral intravenous catheter placement including 10 supervised ultrasound-guided peripheral intravenous catheter placements. In total, 87% (3513/4053) of the ultrasound-guided peripheral intravenous catheter placed after the training program were successful on the first attempt. The probability of successfully placing an ultrasound-guided peripheral intravenous catheter increased as nurses had more experience placing ultrasound-guided peripheral intravenous catheters (R2 = 0.18) and was 83% at 10 encounters. Twenty-five percent (904/3646) of ultrasound-guided peripheral intravenous catheters had complications, and there was no statistically significant relationship between the number of encounters per nurse and complication rates (R2 < 0.001). Conclusion: Nurses can reliably place ultrasound-guided peripheral intravenous catheters at a high success rate after an initial training period. First-attempt success rates were high and increased from 67% to 83% for the first 10 unsupervised encounters after training and remained high. The complication rate was low and did not change as nurses gained more experience.

Lifespan of peripheral intravenous short catheters in hospitalized children: A prospective study

2021 ◽  
pp. 112972982110052
Author(s):  
Maria Elizabeth Gómez-Neva ◽  
Martin Alonso Rondon Sepulveda ◽  
Adriana Buitrago-Lopez
Keyword(s):  
Cohort Study ◽  
Prospective Study ◽  
The Other ◽  
Hospitalized Children ◽  
Intravenous Catheter ◽  
Survival Analyses ◽  
Median Lifespan ◽  
Pediatric Services ◽  
A Prospective Study ◽  
Intravenous Catheters

Objective: To estimate the recommended lifespan of 223 peripheral intravenous accesses in pediatric services. Method: In this cohort study, we monitored the time of intravenous catheter between insertion and removal in children aged up to 15 years old in a Hospital from Bogotá-Colombia. The routine catheter observations was registered in questionnaires during nursing shifts. Survival analyses were performed to analyze the lifespan of the catheter free of complications. Results: The median lifespan of peripheral intravenous catheters without complications was 129 h (IQR 73.6–393.4 h). This median time free from complications was much lower for children ⩽1 year 98.3 h (IQR 63–141 h), than for participants aged >1 year 207.4 h (IQR 100–393 h). Catheters of 24 G (gauge) caliber had a median complication free time of 128 h (IQR 69–207 h) and 22 G calibers 144 h (IQR 103–393 h). Conclusions: In this study, 75% of peripheral indwell catheters remained free from complications for 74 h, the other extreme 25% of these patients could remain up to 393 h.

scholarly journals Peripheral Intravenous Catheter Placement Is an Underrecognized Source of Staphylococcus aureus Bloodstream Infection

2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Eloise D. Austin ◽  
Sean B. Sullivan ◽  
Susan Whittier ◽  
Franklin D. Lowy ◽  
Anne-Catrin Uhlemann
Keyword(s):  
Staphylococcus Aureus ◽  
Bloodstream Infection ◽  
Catheter Placement ◽  
Intravenous Catheter ◽  
Staphylococcus Aureus Bacteremia ◽  
Peripheral Intravenous Catheter ◽  
Life Threatening ◽  
Staphylococcus Aureus Bloodstream Infection ◽  
Life Threatening Complication ◽  
Intravenous Catheters

Abstract Few studies have focused on the risks of peripheral intravenous catheters (PIVs) as sources for Staphylococcus aureus bacteremia (SAB), a life-threatening complication. We identified 34 PIV-related infections (7.6%) in a cohort of 445 patients with SAB. Peripheral intravenous catheter-related SAB was associated with significantly longer bacteremia duration and thrombophlebitis at old PIV sites rather than current PIVs.

Assessment of Losartan 50 mg on Survival of Post-Dialysis Euvolemic Hypertensive Patients: Findings from HELD Trial

2019 ◽  
Vol 48 (3) ◽  
pp. 233-242
Author(s):  
Raja Ahsan Aftab ◽  
Amer Hayat Khan ◽  
Azreen Syazril Adnan ◽  
Syed Azhar Syed Sulaiman ◽  
Tahir Mehmood Khan
Keyword(s):  
Cox Regression ◽  
Dialysis Session ◽  
Hypertensive Patients ◽  
Cox Regression Analysis ◽  
Probability Of Survival ◽  
End Point ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Single Blind

Aims and objective: To estimate the effect of losartan 50 mg on survival of post-dialysis euvolemic hypertensive patients. Methodology: A single center, prospective, single-blind randomized trial was conducted to estimate the survival of post-dialysis euvolemic hypertensive patients when treated with lorsartan 50 mg every other day. Post-dialysis euvolemic assessment was done by a body composition monitor. Covariate Adaptive Randomization was used for allocation of participants to the standard or intervention arm, and the follow-up duration was twelve months. The primary end point was achieving targeted blood pressure (BP) of <140/90 mm Hg and maintaining for 4 weeks, whereas secondary end point was all cause of mortality. Pre-, intra-, and post-dialysis session BP measurements were recorded, and survival trends were analyzed using Kaplan-Meier analysis. Results: Of the total 229 patients, 96 (41.9%) were identified as post-dialysis euvolemic hypertensive. Final samples of 88 (40.1%) patients were randomized into standard (n = 44) and intervention arms (n = 44), and 36 (81.8%) patients in each arm completed a follow-up of 12 months. A total of eight patients passed away during the 12-month follow-up period (6 deaths among standard arm and 2 in intervention arm). However, the probability of survival between both arms was not significant (p = 0.13). Cox regression analysis revealed that chances of survival were higher among the patients in the intervention (OR 3.17) arm than the standard arm (OR 0.31); however, the survival was found not statistically significant. Conclusion: There was no statistical significant difference in 1 year survival of post-dialysis euvolemic hypertensive patients when treated with losartan 50 mg.

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