Review article: Idle ‘just‐in‐case’ peripheral intravenous cannulas in the emergency department: Is something wrong?

Gledstone-Brown, Lynne; McHugh, Douglas

doi:10.1111/1742-6723.12877

Cited by 30 publications

(30 citation statements)

References 34 publications

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“…Although venous puncture is generally considered to generate only low-intensity pain, our study confirms previous research findings that there is a clinically significant difference between the sensation of pain described by patients with DPIVC and that of patients who do not present this difficulty [29,30]. Situations of difficult access, as well as provoking multiple punctures, often result in cannulation manoeuvres that generate more tissue damage, with possible adverse effects for the patient, thus degrading the quality of healthcare and the user's satisfaction [3,31,32].…”

Section: Discussionsupporting

confidence: 86%

Risk Factors for Difficult Peripheral Intravenous Cannulation. The PIVV2 Multicentre Case-Control Study

Rodríguez-Calero

Pedro-Gómez

Molero-Ballester

et al. 2020

JCM

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Background. Difficult peripheral intravenous cannulation (DPIVC) is associated with serious complications related to vascular access. These complications might be avoided if the risk factors were identified previously, enabling the detection of potentially difficult situations at an early stage. The aim of this study is to consider these risk factors, to determine the influence of the hospital setting, to examine the association between DPIVC and the different techniques of catheter insertion and to analyse the importance of the clinician’s experience in this context. Methods. Case-control study following a previously published protocol, conducted in 48 units of eight public hospitals in Spain. Adult patients requiring a peripheral intravenous cannula were prospectively included in the study population during their hospital stay. Over a period of 11 months, for consecutive eligible patients, nurses in each participating unit recorded data on their assessment of the vascular access performed and the technique used. Variables related to these medical personnel were also recorded. One of the researchers reviewed the patients’ clinical history to compile the relevant health variables and to characterise the healthcare process. The statistical analysis included association tests among the main study variables. The risk factors were analysed using bivariate logistic regression. The variables found to be statistically significant were included in a multivariate logistic regression model incorporating each of the healthcare environments identified. Results. The study population was composed of 2662 patients, of whom 221 (8.3%) presented with DPIVC. A previous history of difficulty, the presence of non-palpable veins, acute upper limb alterations and punctures in the ante-cubital fossa were found to be independent risk factors for DPIVC. Differences were found in the frequency of occurrence of DPIVC and in some risk factors, according to the healthcare context. The variables related to the characteristics of the hospital personnel did not influence the study event. Conclusion: The present study identifies four independent risk factors for DPIVC that can be incorporated into algorithms aimed at preventing its occurrence and facilitating the referral of patients to vascular access specialist teams.

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Section: Discussionsupporting

confidence: 86%

Risk Factors for Difficult Peripheral Intravenous Cannulation. The PIVV2 Multicentre Case-Control Study

Rodríguez-Calero

Pedro-Gómez

Molero-Ballester

et al. 2020

JCM

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“…Although the clinical need for a PIVC is sometimes obvious, many are inserted in haemodynamically stable patients without a clear or immediate requirement. These PIVCs are often placed 'just in case,' with negligible potential bene ts, and studies report up to 50% remain idle and are never used (16,17) .…”

Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Idle peripheral intravenous cannulation: An observational cohort study of pre-hospital and emergency department practices

Evison

Sweeny²,

Ranse

et al. 2020

Preprint

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Background Unused ('idle') peripheral intravenous catheters (PIVC) are those not used within 24 hours of insertion. There is little data on cannulation practices and idle PIVC rates in emergency settings, especially the pre-hospital environment. Methods This was an observational cohort study set in south-east Queensland, Australia using data from a large tertiary level emergency department (ED) and the local statutory ambulance service. Demographic, clinical and PIVC data were collected over two periods; 9 February - 18 March 2017 and 5 January - 4 February 2018. Adult patients were included if they were allocated an Australasian triage scale (ATS) category between 2 and 5, and had a PIVC inserted in the pre-hospital setting or ED. PIVC use was defined as idle if no fluids, medications or contrast were administered intravenously within 24 hours of insertion. Comparisons between pre-hospital and ED practice and idle PIVC status were undertaken using descriptive statistics and logistic regression.Results A total of 1249 patients with a PIVC (372 pre-hospital; 877 ED) were included. Overall, 366 PIVCs (29.3%; 95% CI 26.9%-31.9%) remained idle at 24h. In the pre-hospital group, 147 (39.5%) PIVCs inserted were not used pre-hospital, and 74 (19.9%) remained idle. In comparison, 292 (33.3%) PIVCs placed in the ED remained idle. ED staff more frequently inserted PIVCs in the antecubital fossa than paramedics (65.5% vs 49.7%), where forearm PIVC insertion was more common pre-hospital than in ED (13.7% vs 7.4%). Nursing staff inserted idle PIVC at a rate of (35.1%) compared to doctors (29.6%) and paramedics (19.9%). Having a PIVC insertion in the ED was the only factor significantly (p=<.001) predicting an idle outcome (Odds Ratio: 2.4; 95%CI 1.7-3.3). Conclusion One-third of PIVCs inserted within the emergency setting remained idle, suggesting unnecessary risk and costs. Pre-hospital and ED PIVC insertion practices differed, with idle PIVCs 2.4 times more prevalent if inserted in the ED than pre-hospital and with greater use of ante-cubital insertion. Reasons for these differences are not well understood and requires more targeted research.

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“…There is increasing evidence that clinicians should act to preserve the integrity of patients' vessels [17]. After inserting a PIVC without clinical indication, if it was leaved or idled, the patients are going to meet avoidable harms and risks [18]. Anecdotal evidence suggests this maybe common in EDs however, accurate assessment of the insertion and use of PIVCs in ED is hard to establish.…”

Section: Discussionmentioning

confidence: 99%

Assessing the Influence of Quality Improvement Methods to Improve the Success Rate of Peripheral Venous Indwelling Needle

Shi¹,

Wang²,

Jiang³

et al. 2020

AJNS

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Objective: To assess the influence of Quality improvement methods to improve the success rate of peripheral venous indwelling needle. Methods: 1613 patients were invested to join our study, they provided 2472 cases of peripheral venous indwelling needle. The time of they received services is from March 2019 to December 2019. They were divided into a control group (participant: n = 595, case: n = 1035) and an intervention group (participant: n =1018, case: n = 1437) according to this time, that patients were invested to join control group who receive services between March 2019 and June 2019, intervention group participants' service time is between June 2019 and December 2019. The control group participants receive routine care model in the PIVC process. About collection, the information includes the success rate of PIVC, complications situation and indwelling time of PIVC. Result: The success rate of PIVC assessment from researcher's report, they record the result of patient's PIVC. Intervention group has higher success rate than that of control group (71.95% vs 49.57%). Most complications were happened in PIVC process. it shows the research result of mainly 4 kinds of complication in the table, the result contains seepage, blocking pipe, take off the tube and phlebitis. In overall, intervention group patients have less complications cases and lower incidence of complications in each kind of complication, except as phlebitis result (p = 0.369). Conclusion: the quality improvement methods can improve the success rate of PIVC and reduce the complications cases of PIVC.

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Review article: Idle ‘just‐in‐case’ peripheral intravenous cannulas in the emergency department: Is something wrong?

Cited by 30 publications

References 34 publications

Risk Factors for Difficult Peripheral Intravenous Cannulation. The PIVV2 Multicentre Case-Control Study

Risk Factors for Difficult Peripheral Intravenous Cannulation. The PIVV2 Multicentre Case-Control Study

WITHDRAWN: Idle peripheral intravenous cannulation: An observational cohort study of pre-hospital and emergency department practices

Assessing the Influence of Quality Improvement Methods to Improve the Success Rate of Peripheral Venous Indwelling Needle

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Review article: Idle ‘just‐in‐case’ peripheral intravenous cannulas in the emergency department: Is something wrong?

Cited by 30 publications

References 34 publications

Risk Factors for Difficult Peripheral Intravenous Cannulation. The PIVV2 Multicentre Case-Control Study

Risk Factors for Difficult Peripheral Intravenous Cannulation. The PIVV2 Multicentre Case-Control Study

WITHDRAWN: Idle&nbsp;peripheral intravenous cannulation: An observational cohort study of pre-hospital and emergency department practices

Assessing the Influence of Quality Improvement Methods to Improve the Success Rate of Peripheral Venous Indwelling Needle

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WITHDRAWN: Idle peripheral intravenous cannulation: An observational cohort study of pre-hospital and emergency department practices