Factors affecting difficult peripheral intravenous cannulation in adults: a prospective observational study

Piredda, Michela; Biagioli, Valentina; Barrella, Beatrice; Carpisassi, Ilaria; Ghinelli, Roberta; Giannarelli, Diana; Marinis, Maria Grazia De

doi:10.1111/jocn.13444

Cited by 55 publications

(96 citation statements)

References 21 publications

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“…30 Seven studies had "diffi cult" or "diffi culty" in their title as a term to use to describe insertion failure. 3,19,[24][25][26][27]30 One study was titled exclusively for the nursing profession, 20 5 studies were reported in medical journals, 3,24,26,29,30 and 6 were reported in nursing journals, [19][20][21][22]25,27 with the remainder published in a vascular access journal. 23,28 General Characteristics of Included Studies…”

Section: Resultsmentioning

confidence: 99%

“…One TRA which was registered as a clinical trial 24 involved a standardized reporting tool as is recommended by the EQUATOR Network. 18 Nine of the 13 papers reported that TRA components were chosen based on identifi ed predictors of successful insertion from observational data 3,19,[23][24][25][26][27][28]30 , with 5 papers using multivariate logistic regression to identify independent predictors. 3,23,24,26,2 At least 4330 insertion attempts on patients were reported.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Tools, Clinical Prediction Rules, and Algorithms for the Insertion of Peripheral Intravenous Catheters in Adult Hospitalized Patients: A Systematic Scoping Review of Literature

Carr

Higgins

Cooke

et al. 2017

Journal of Hospital Medicine

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Tools, Clinical Prediction Rules, and Algorithms for the Insertion of Peripheral Intravenous Catheters in Adult Hospitalized Patients: A Systematic Scoping Review of Literature

Carr

Higgins

Cooke

et al. 2017

Journal of Hospital Medicine

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“…The literature search found ten studies investigating 21 patient risk factors, including age, gender, race, weight/BMI, medical diseases and conditions (such as diabetes, cancer, lymphadenectomy, previous chemotherapy or radiotherapy, oedema, parenteral drug abuse) (Armenteros‐Yeguas et al, ; Bensghir et al, ; Carr, Rippey, Cooke, et al, ; Fields, Piela, Au, & Ku, ; Jacobson & Winslow, ; Juvin, Blarel, Bruno, & Desmonts, ; Lapostolle et al, ; Van Loon, Puijn, Houterman, & Bouwman, ; Piredda et al, ; Sebbane et al, ).…”

Section: Methodsmentioning

confidence: 99%

“…The evidence is summarised in Table . The risk factors for DIVA classified as strong evidence were as follows: gender, BMI, lymphadenopathy, chemotherapy through PIVC or port and hypovolaemia (Armenteros‐Yeguas et al, ; Bensghir et al, ; Fields et al, ; Juvin et al, ; Van Loon et al, ; Piredda et al, ; Sebbane et al, ).…”

Section: Methodsmentioning

confidence: 99%

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Risk factors for a difficult intravenous access: A multicentre study comparing nurses' beliefs to evidence

Piredda

Fiorini

Facchinetti

et al. 2019

Journal of Clinical Nursing

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Aims and objectives To summarise the evidence about patient‐related risk factors for difficult intravenous access in adults, and at identifying nurses' beliefs and their consistency with evidence. Background Peripheral intravenous cannulation is a common procedure for nurses, but rates of failure at first attempt of peripheral intravenous cannulation range 10%–40%. Nurses' beliefs about difficult intravenous access factors might influence their clinical practice more than current evidence. Design The study included a literature review of the evidence on patient‐related risk factors for difficult intravenous access, the development of an instrument to investigate nurses' beliefs about this topic and a cross‐sectional multicentre survey on clinical nurses. Methods The quality of the studies included was evaluated through the Quality Assessment Tool for Observational Cohort and Cross‐Sectional Studies. A synthesis of evidence for each risk factor was produced. A survey instrument was developed including 26 risk factors, which were then rated by nurses as perceived predictors of difficult intravenous access. The STROBE guidelines for study reporting were followed. Results Four hundred and fifty clinical nurses working in four hospitals in Italy were surveyed. Nurses' beliefs were in line with evidence in considering body mass index, drug abuse, lymphadenectomy and chemotherapy as difficult intravenous access factors. Beliefs about difficult intravenous access factors were influenced by nurses' work experience and frequency of peripheral intravenous cannulation. Nurses also identified as risk factors for difficult intravenous access oedema, thrombophlebitis, hypovolaemia, skin lesions and irritant therapies, which have been minimally investigated by research. Conclusions An overall congruence between nurses' beliefs and evidence about risk factors for difficult intravenous access was found. With their expertise, nurses may fill the knowledge gap of clinical evidence and open new paths for clinically meaningful research. Relevance to clinical practice Nurses' beliefs about difficult intravenous access factors can be influenced by their work experience and clinical setting. Integrating nurses' beliefs with scientific evidence can increase the quality of care.

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Remotely supervised ultrasound‐guided peripheral intravenous cannulation training: A prospective cohort study examining success rates and patient experience

Peters

Thomas

Woods

et al. 2022

Australas J Ultrason Med

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Introduction Ultrasound‐guided peripheral intravenous cannulation (USGPIVC) benefits patients with difficult intravenous access (DIVA) through visualising otherwise non‐visible and non‐palpable veins. Supervised live‐case training is an important component of learning this skill, but supervisor availability can present a barrier limiting or delaying staff completing their training. Aims The aim of this study was to determine the first‐attempt success rate of newly trained USGPIVC inserters using remote supervision and timely written feedback based on app‐based screen recordings taken during insertion. Secondary aims were overall procedural success, and inserter and patient experiences. Methods This study is an observational cohort study carried out between October and December 2021. Fourteen newly trained junior medical officers (JMOs) were eligible to utilise USGPIVC on a minimum of five consenting patients while simultaneously recording the ultrasound screen during insertion to capture their technique. Feedback was generated following expert review of these recordings against a standardised feedback tool. Results Average first‐attempt success was 71% (n = 72) in the 102 patients recruited. The average time for JMOs to receive feedback was 30 h, and 13 JMOs (93%) felt well supported and completed the remote training pathway. The majority of patients were female (n = 59; 58%), were aged 41–80 years (n = 75; 74%) and had ≥2 risk factors for DIVA (n = 57; 56%). Conclusions First‐attempt success rates were similar when comparing remote supervision used in this study to direct supervision used by other studies.This finding supports incorporating remote supervision into training guidelines for USGPIVC as an alternative method of supervision, particularly when supervisor availability is limited.

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Factors affecting difficult peripheral intravenous cannulation in adults: a prospective observational study

Abstract: These results can help nurses to recognise risk factors for difficult intravenous access and pay appropriate attention when attempting a venepuncture to preserve patients' peripheral veins.

Cited by 55 publications

References 21 publications

Tools, Clinical Prediction Rules, and Algorithms for the Insertion of Peripheral Intravenous Catheters in Adult Hospitalized Patients: A Systematic Scoping Review of Literature

Tools, Clinical Prediction Rules, and Algorithms for the Insertion of Peripheral Intravenous Catheters in Adult Hospitalized Patients: A Systematic Scoping Review of Literature

Risk factors for a difficult intravenous access: A multicentre study comparing nurses' beliefs to evidence

Remotely supervised ultrasound‐guided peripheral intravenous cannulation training: A prospective cohort study examining success rates and patient experience

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