Articles

Findings: The insertion of peripheral IV catheters in an inpatient setting can be time intensive and requires significant skill.The median cost of the pediatric IV insertions was $41, and 60% of the placements were obtained with the first nurse. Seventy-two percent of the children had a successful IV insertion in 1 to 2 attempts and accounted for 53% of total costs. However, the 28% of children who required > or = 3 IV attempts had a cost range of $69 to more than $125, and they consumed 43% of the total IV costs. This subset was often < 2 years old or dehydrated (P = .0002).

Conclusions: The incidence of PICC related CLABSI is 5.2% (76 of 1423) for hospitalized patients; inpatient use of PICCs has the same incidence of infection as central lines.Although PICCs are associated with a lower risk of CLABSI than CVCs in outpatients, hospitalized patients may be just as likely to experience CLABSI with PICCs as with CVCs. Consideration of risks and benefits before PICC use in inpatient settings is warranted.

Conclusions: We identified that a positive patient experience is associated with increased profitability and a negative patient experience is even more strongly associated with decreased profitability.

Key Points: Successful venipuncture is critical in providing timely diagnosis and treatments for patients. Multiple attempts and a delay in obtaining vascular access negatively affect patients and ED staff. Failure of clinical technicians or nurses to place SPCs often leads to more advanced procedures, such as the insertion of central vascular access devices (CVADs), which are more costly and increase risks to patient safety. The presence of difficult vein access (DVA) among patients had a profound effect on ED staff and physical resources. Results from the triage vascular access observations showed difficult vascular catheter placements took on average 3 times longer than simple vascular access insertions. Results from this assessment suggest that difficult vascular access represents tangible threats to patient safety and increased use of resources.

Conclusion: DVA occurred in 37% of patients treated at four French Haemophilia Treatment Centers. This high frequency suggests the need for improved approaches in peripheral venous access. AccuVein improved the ability to locate veins among patient with difficult venous access (92.3% of DVA patients were classified as difficult to locate veins while 76% of DVA patients were considered difficult with AccuVein). Since difficulty locating veins was encountered in 92% of DVA patients by conventional methods, new technology to facilitate vein localization could help address the problem. In this study, use of AccuVein NIR vein visualizer was associated with significantly decreased difficulty in vein location and reduced pain. Further investigation of the clinical role for this technology is warranted.

Conclusion: Near-infrared devices may improve the first-attempt success rate in children with difficult intravenous access by allowing healthcare professionals to visualize the peripheral veins. Therefore, we suggest that the difficult intravenous-access score be used as a screening tool to suggest when to apply near-infrared devices to children with difficult peripheral intravenous access in order to maximize efficacy of treatment.

Conclusion: Barriers to implementing Evidence Based Practice (EBP) in healthcare are numerous, resulting in lower quality of care delivery, risks to patient safety, and increased costs (Mazurek Melnyk et al, 2021). Inadequate resources, lack of leadership support, and lack of clinician education related to implementation science creates a barrier to EBP (Mathieson et al, 2019).

The Clinical Technology Implementation Model(CTIM) offers an effective instrument that is founded in change theory and implementation science and gives considerable attention to addressing change resistance. Simple removal of resistant individuals is not a realistic approach to dealing with change resistance. The CTIM offers a realistic approach to addressing resistance to EBP changes and technology adoption.

For PIVC placement, it is critical to use technologies, such as the AccuVein AV500, to enhance compliance with EBP and support better outcomes for patients. Vessel preservation is the goal for the 2024 INS standards of practice (Nickel et al, 2024) and adoption of AccuVein AV500 vein visualisation technology to enhance PIV assessment offers an innovative and practical intervention to achieve this goal.

Conclusion: Near-infrared technology vein illumination device (AccuVein AV400®) improved venous cannulation and the availability of near-infrared technology appears to increase staff’s confidence in attempting vein cannulation.

There was a 45% declined escalation calls following device implementation.

Key Points: Prior to PIVC insertion, it is important that an appropriate insertion site has been selected (the forearm is preferred, avoiding joints). The chosen vein for insertion should be inspected and carefully palpated. Potential aids for improving venous access success should be considered. These may include vein visualisation tools (near infrared light or ultrasound, as available).

Studies indicate that the overall IV catheter failure rate (failure before the intended end date of use) lies between 35% and 50%.Whatever the cause, PIVC failure, by its very nature, can lead to personal discomfort for patients and requires additional medical treatment. PIVC failure is costly to healthcare systems, due to the increase in need for medical resources and patient’s additional length of hospital stay.

Conclusion: Use of AccuVein AV400, a vein illumination device based on infrared technology, can significantly improve the success rate of vein cannulation at the first attempt in patients affected by obesity where obtaining vascular access is a well-known challenge.

Results from this clinical investigation show that using the device will improve the rate of rapidly starting a peripheral IV by more than 3 fold. Also, the beneficial impact of using this medical tool is increased in certain patient categories such as female gender, older subjects and patients with darker skin color as it is demonstrated by the Odds Ratios from a multivariate regression.

Abstract: Success was determined based on the number of attempts per patient, the duration of the procedure, and the first stick success rate. This was a randomized, controlled experimental study on 129 children aged 3 to 18 years.The duration of peripheral intravenous catheterization was shorter in the study group (S) than in the control (C) patients (37.24 ± 20.07 vs 172.65 ± 153.21 seconds; P = 0.001), with fewer attempts (S, 1.08 ± 0.28; C, 2.23 ± 1.57; P < 0.01). The first stick success rate was higher in the control group (S, 91.7%; C, 47.4%; P = 0.001).

Peripheral intravenous catheterization using vein visualization device support reduces the number of attempts per patient and the operation duration and increases the rate of first stick success. We may therefore state that vein visualization device support improves the success of peripheral intravenous catheterization.

Excerpt: The use of NIR significantly increased intravenous access success rates when compared with visualization or palpation (26% vs 19.6%; P < 0.0001). Modality had a statistically significant effect on the number of attempts (P < 0.0001), but only a slight clinical significance (NIR, up to 1-4 attempts and ultrasound or transillumination combined, 1-6 attempts). Conclusions: NIR decreases the number of attempts and improve overall success rates in acquiring PVA in CSHCN. Further studies on maximizing PVA success in this patient population are warranted.

Conclusion: Dwell time of the PIVC was 24% longer in the infrared (AccuVein) group than in the transilluminator and control groups. Time to successful cannulation was significantly lower for the infrared group than for the transilluminator (81% quicker) and control groups (50% quicker). In addition, procedural pain levels were lower in the infrared and control groups than in the transilluminator group.

Conclusion: AccuVein AV400 reduces the procedure time, decreases the number of attempts, increases success rate in first attempt and lowers the pain felt during the PIC placement procedure in pediatric patients aged 0-3. In light of these results, it can be said that the device increases the success of the PIC placement procedure in pediatric patients aged 0-3. Its use can be recommended for PIC placement procedure, especially in children with difficult veins.

Abstract: Placement of peripheral intravenous catheters (PIVCs) is a frequent occurrence. Yet, PIVCs consistently require multiple attempts for successful cannulation, leading to an increased use of resources and risk of complications. Even though hospitals have established vascular access teams to improve outcomes and increase longevity of PIVCs, not every facility has one, and some struggle to meet demand. In these cases, PIVC placement depends on the confidence and skills of bedside nurses. Difficult access risk identification tools, as well as vein visualization technologies, like near infrared (nIR), have been developed to assist nurses with cannulation. This study sought to explore how hospitals are using vein visualization technology in nurse-driven protocols and to evaluate whether the technology is being meaningfully integrated into venous assessment and PIVC access protocols. In a survey sent to facilities utilizing nIR technology, 48% of respondents incorporated nIR in nurse-driven protocols. Of these respondents, 88% reported improvement in patient satisfaction, 92% saw a reduction in escalations, and 79% reported a reduction in hospital-acquired infections associated with PIVC placement. Integrating vein visualization technology into nurse-driven PIVC placement protocols has the potential to make a positive impact but requires future research to reproduce these findings in clinical studies.

Conclusions: We identified that a positive patient experience is associated with increased profitability and a negative patient experience is even more strongly associated with decreased profitability.

Conclusions: In this AccuVein survey 93% of the participants stated that they would give a higher satisfaction score if vein illumination was used.