Amanda J Ullman1, Mari Takashima2, Tricia Kleidon3, Gillian Ray-Barruel4, Evan Alexandrou5, Claire M Rickard6. 1. Alliance for Vascular Access Teaching and Research, Menzies Health Institute Queensland, Nathan, Queensland, Australia; School of Nursing and Midwifery, Griffith University, Nathan, Queensland, Australia; Royal Brisbane and Women's Hospital, Herston, Queensland, Australia; Queensland Children's Hospital, South Brisbane, Queensland, Australia. Electronic address: a.ullman@griffith.edu.au. 2. Alliance for Vascular Access Teaching and Research, Menzies Health Institute Queensland, Nathan, Queensland, Australia. 3. Alliance for Vascular Access Teaching and Research, Menzies Health Institute Queensland, Nathan, Queensland, Australia; Queensland Children's Hospital, South Brisbane, Queensland, Australia. 4. Alliance for Vascular Access Teaching and Research, Menzies Health Institute Queensland, Nathan, Queensland, Australia; School of Nursing and Midwifery, Griffith University, Nathan, Queensland, Australia; Royal Brisbane and Women's Hospital, Herston, Queensland, Australia; Queen Elizabeth II Jubilee Hospital, Coopers Plains, Queensland, Australia. 5. Alliance for Vascular Access Teaching and Research, Menzies Health Institute Queensland, Nathan, Queensland, Australia; Western Sydney University, Sydney, New South Wales, Australia; Department of Intensive Care, Liverpool Hospital, New South Wales, Australia. 6. Alliance for Vascular Access Teaching and Research, Menzies Health Institute Queensland, Nathan, Queensland, Australia; School of Nursing and Midwifery, Griffith University, Nathan, Queensland, Australia; Royal Brisbane and Women's Hospital, Herston, Queensland, Australia; Queensland Children's Hospital, South Brisbane, Queensland, Australia.
Abstract
PURPOSE: To describe worldwide characteristics, performance and risk factors of peripheral intravenous catheters (PIVCs), in pediatrics. DESIGN: A secondary, subgroup analysis of pediatric (<18 years) data was undertaken, using a global, cross-sectional study of PIVCs. Practice characteristics included: demographic, diagnostic, utility, management, performance and resources. Multivariate regression identified complication risks factors. RESULTS: Data from 4206 children in 278 hospitals across 47 countries. Most PIVCs (outside of Australia, New Zealand) were inserted by nurses (71%; n = 2950), with dedicated teams only common in North America (23.2%; n = 85). Large gauges (≤18G) were mostly used in South America, Europe and Africa. Regions predominantly placed 24G (49%; n = 2060) except in Australia and New Zealand, who more commonly placed 22G (38.7%; n = 192). The most common placement was the hand (51%; n = 2143), however North America, Australia and New Zealand frequently utilised the antecubital fossa (24.5%, n = 90; 21.4%; n = 106). Polyurethane dressings were most used (67.1%; 2822), and many were not clean, dry and intact (17.1%; n = 715). Over 8% of PIVCs were idle, with the highest rates in North America (21.2%; n = 78). PIVC local complication risk factors included: >2 years age (odds ratio [OR] > 1.58; 1.2-2.1); ambulance/emergency insertion (OR 1.65; 1.2-2.3); upper arm/antecubital placement (OR 1.44; 1.1-2.0); poor dressing integrity (OR 5.4; 4.2-6.9); and 24-72 h dwell (OR > 1.9; 1.3-2.6). CONCLUSIONS: There is global inconsistency in pediatric PIVC practice, which may be causing harm. CLINICAL IMPLICATIONS: Improvements in pediatric PIVC placement, dressings, and gauge selection are needed.
PURPOSE: To describe worldwide characteristics, performance and risk factors of peripheral intravenous catheters (PIVCs), in pediatrics. DESIGN: A secondary, subgroup analysis of pediatric (<18 years) data was undertaken, using a global, cross-sectional study of PIVCs. Practice characteristics included: demographic, diagnostic, utility, management, performance and resources. Multivariate regression identified complication risks factors. RESULTS: Data from 4206 children in 278 hospitals across 47 countries. Most PIVCs (outside of Australia, New Zealand) were inserted by nurses (71%; n = 2950), with dedicated teams only common in North America (23.2%; n = 85). Large gauges (≤18G) were mostly used in South America, Europe and Africa. Regions predominantly placed 24G (49%; n = 2060) except in Australia and New Zealand, who more commonly placed 22G (38.7%; n = 192). The most common placement was the hand (51%; n = 2143), however North America, Australia and New Zealand frequently utilised the antecubital fossa (24.5%, n = 90; 21.4%; n = 106). Polyurethane dressings were most used (67.1%; 2822), and many were not clean, dry and intact (17.1%; n = 715). Over 8% of PIVCs were idle, with the highest rates in North America (21.2%; n = 78). PIVC local complication risk factors included: >2 years age (odds ratio [OR] > 1.58; 1.2-2.1); ambulance/emergency insertion (OR 1.65; 1.2-2.3); upper arm/antecubital placement (OR 1.44; 1.1-2.0); poor dressing integrity (OR 5.4; 4.2-6.9); and 24-72 h dwell (OR > 1.9; 1.3-2.6). CONCLUSIONS: There is global inconsistency in pediatric PIVC practice, which may be causing harm. CLINICAL IMPLICATIONS: Improvements in pediatric PIVC placement, dressings, and gauge selection are needed.
Authors: Jessica A Schults; Tricia M Kleidon; Victoria Gibson; Robert S Ware; Emily Monteagle; Rebecca Paterson; Karina Charles; Adam Keys; Craig A McBride; Steven McTaggart; Benjamin Lawton; Fiona Macfarlane; Chloe Sells; Claire M Rickard; Amanda J Ullman Journal: BMC Health Serv Res Date: 2022-02-17 Impact factor: 2.655
Authors: Luciano Marques Dos Santos; Katharinne de Jesus Nunes; Cleonara Sousa Gomes E Silva; Denise Miyuki Kusahara; Elisa da Conceição Rodrigues; Ariane Ferreira Machado Avelar Journal: Rev Lat Am Enfermagem Date: 2021-06-28