Reducing Risks and Improving Vascular Access Outcomes.
Elizabeth Morrell
PMID 32618956WHAT IT FOUND
For nurses who insert peripheral IVs, a bundled vascular access program was associated with better documented first-attempt success, less insertion-site leakage, and longer dwell time.
The bundle changed several things at once.
Key findings
01When undocumented cases were included, reported first-attempt success increased by 30% after the vascular access program.
02Blood or fluid leakage from an insertion site decreased from 18% to 1% after the vascular access program.
03Average catheter dwell time increased by 53 hours, or 79%, between preprogram and postprogram groups.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a before-and-after quality improvement study without a control group, so other changes over time could explain the improvements. The program changed several things at once: a new closed catheter system, staff training, continuing education, policy updates, and process recommendations, so the contribution of any single component cannot be separated. The health care system partnered with a device company that supported assessments, training, and open-access publication. The later follow-up was done at only one hospital, so results may not reflect the whole system. Staff turnover over the observation period may have affected training and practice.
Declared interests
Becton, Dickinson and Company supported assessments and training and funded open access. The author declared no other conflicts.
The easy way to misread this
Do not conclude that the new closed catheter system alone caused the improvements. The program also included training, continuing education, policy updates, and process recommendations, and the study had no control group.