Prevalence of difficult venous access and associated risk factors in highly complex hospitalised patients.
Victoria Armenteros-Yeguas, Lucía Gárate-Echenique, Maria Aranzazu Tomás-López and 4 others
PMID 28165645WHAT IT FOUND
Difficult venous access was frequent in highly complex hospitalised patients, and female sex was the only factor that remained linked to it after accounting for other factors.
A history of repeated cannulation mattered more than absent visible veins.
Key findings
01Difficult venous access was common in this highly complex hospitalised population, and it was defined mainly by a history of repeated intravenous line attempts.
02Female sex was the only factor that remained linked to difficult venous access after adjustment.
03Osteoarticular disease and previous vascular access complications were linked to difficult venous access in unadjusted analysis.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was not random and came from two hospitals, so it may not represent other settings. Difficulty was assessed after recruitment and partly from patient recall of prior punctures, with possible memory bias. Medical records often did not record the number of attempts. The experience and skill of the nurses who placed previous catheters were not measured. The cross-sectional design can show association but not cause.
Declared interests
The study was funded by the Basque health department through a health research grant. The authors declared no conflicts of interest.
The easy way to misread this
Do not read this as evidence that avoiding repeated attempts will prevent difficult venous access. The study measured prevalence and associations at one time point, and part of the definition relied on patient-reported history, so it cannot establish cause.