Literature DB >> 27324945

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

Michela Piredda1, Valentina Biagioli2, Beatrice Barrella1, Ilaria Carpisassi1, Roberta Ghinelli1, Diana Giannarelli3, Maria Grazia De Marinis1.   

Abstract

AIMS AND
OBJECTIVES: This study aimed to identify risk factors for difficult intravenous cannulation in relation to characteristics of patients, healthcare providers and devices in adult patients accessing a radiology service.
BACKGROUND: Early recognition of patients at risk for difficult peripheral intravenous catheterisation is important to adopt strategies able to increase the likelihood of success in intravenous cannulation, as well as to critically evaluate the use of alternative administration routes or venous devices.
DESIGN: A prospective observational study was conducted in the radiology service of an Italian university hospital from January to August 2013.
METHODS: Thirteen nurses observed 763 patients during intravenous insertion (53% were female, the mean age was 63 years and 65% had a diagnosis of cancer). For each patient, nurses collected data about potential predictors of difficult intravenous cannulation, which was defined as a procedure lasting more than one minute. Data included characteristics of patient, cannula required, venepuncture performed and operator(s) involved. Logistic regression was performed as univariate and multivariate analysis.
RESULTS: The intravenous insertion time ranged from 45 seconds to 125 minutes. Overall, variables identified as significant independent predictors were chemotherapy received via peripheral cannula (OR = 1·42), veins with many valves (OR = 3·67), fragility (OR = 3·29), visibility (OR = 0·87) and palpability (OR = 0·79) as perceived by nurses.
CONCLUSIONS: Although many risk factors were identified, the overall success rate was very high, suggesting that nurses' attention during cannulation protected at-risk patients from multiple attempts. Multicentre studies should further investigate risk factors across different radiology services and clinical settings. RELEVANCE TO CLINICAL PRACTICE: 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.
© 2016 John Wiley & Sons Ltd.

Entities:  

Keywords:  adult nursing; nursing intervention; observational study; peripheral catheterization; risk assessment

Mesh:

Year:  2017        PMID: 27324945     DOI: 10.1111/jocn.13444

Source DB:  PubMed          Journal:  J Clin Nurs        ISSN: 0962-1067            Impact factor:   3.036


  8 in total

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2.  The Modified A-DIVA Scale as a Predictive Tool for Prospective Identification of Adult Patients at Risk of a Difficult Intravenous Access: A Multicenter Validation Study.

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

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8.  Translation and Validation of the Modified A-DIVA Scale to European Portuguese: Difficult Intravenous Access Scale for Adult Patients.

Authors:  Paulo Santos-Costa; Liliana B Sousa; Fredericus H J van Loon; Anabela Salgueiro-Oliveira; Pedro Parreira; Margarida Vieira; João Graveto
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  8 in total

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