A Prospective Cohort Study of Technique and Technology Used to Improve First Time PIVC Insertion Success in Hospitalised Paediatric Patients.
Tricia M Kleidon, Mari Takashima, Claire M Rickard and 3 others
PMID 39917959WHAT IT FOUND
In hospitalised children, only 156 of 250 peripheral IVs were placed on the first attempt.
Vascular access specialists and ultrasound guidance were linked with higher first-attempt success among final successful inserters.
Key findings
01The analysis included 199 children and 250 PIVCs, and 156 of the 250 PIVCs had first-time insertion success.
02Older age and greater weight were associated with higher first-attempt success, while a history of prematurity was associated with lower first-attempt success.
03For the final successful inserter, vascular access specialists were more likely to succeed on the first attempt, and ultrasound guidance was associated with higher first-attempt success after adjustment for difficult IV access risk.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was conducted at a single quaternary paediatric hospital, so the results may not transfer to other settings. Not all eligible PIVC insertions were captured because of staff availability and recruitment limits, which may have biased the sample. The technique and technology analysis used first-time success by the final successful inserter, not success by the first clinician who attempted the insertion, so it does not show which strategy prevented repeated attempts for every patient. The study was observational, so it cannot prove that vascular access specialists or ultrasound caused higher success. Vein size was not collected for all insertions, and some data were extracted from records rather than observed directly.
Declared interests
Several authors' employers received investigator-initiated research or educational grants, consultancy, commercialisation, or sponsored trial funding from vascular access product manufacturers. Other authors declared no conflicts. The paper does not state that a manufacturer designed or wrote the study.
The easy way to misread this
Do not read this as proof that vascular access specialists or ultrasound cause higher first-attempt success. This was an observational cohort, and the technique and technology analysis used the final successful inserter outcome, so confounding and selection may explain the associations.