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dc.contributor.authorCarr, Peter J
dc.contributor.authorRippey, James CR
dc.contributor.authorCooke, Marie L
dc.contributor.authorTrevenen, Michelle L
dc.contributor.authorHiggins, Niall S
dc.contributor.authorFoale, Aileen S
dc.contributor.authorRickard, Claire M
dc.date.accessioned2019-07-08T01:50:43Z
dc.date.available2019-07-08T01:50:43Z
dc.date.issued2019
dc.identifier.issn2044-6055
dc.identifier.doi10.1136/bmjopen-2018-022278
dc.identifier.urihttp://hdl.handle.net/10072/386228
dc.description.abstractObjectives: This study aimed to identify the incidence of and factors associated with peripheral intravenous catheter/cannula (PIVC) first time insertion success (FTIS) in the emergency department (ED). Design: Prospective cohort study. Setting: Two tertiary EDs in Western Australia. Participants: 879 ED patients. Primary outcome: To identify factors affecting FTIS using univariate and multivariate logistic regression modelling. We created four models: patient factors only; clinician factors only; products and technology factors only and all factors model. We assessed each model’s performance using area under the receiver operating characteristic curve. Results: A total of 1201 PIVCs were inserted in 879 patients. The mean age was 60.3 (SD 22) years with slightly more females (52%). The FTIS rate was 73%, with 128 (15%) requiring a second attempt and 83 (9%) requiring three or more attempts. A small percentage (3%) had no recorded number of subsequent attempts. FTIS was related to the following patient factors: age (for a 1-year increase in age: OR 0.99, 95% CI 0.983 to 0.998; p=0.0097); and target vein palpability: (always palpable vs never palpable: OR 3.53 95% CI 1.64 to 7.60; only palpable with tourniquet vs never palpable: OR 2.20, 95% CI 1.06 to 4.57; p=0.0014). Clinician factors related to FTIS include: clinicians with greater confidence (p<0.0001) and insertion experience (301–1000 vs <301: OR 1.54, 95% CI 1.02 to 2.34; >1000 vs <301: OR 2.07, 95% CI 1.41 to 3.04; p=0.0011). The final all factors model combining patient factors; clinician factors and product and technology factors has greater discriminative ability than specific factors models. It has a sensitivity of 74.26%, specificity of 57.69%, positive predictive value of 82.87% and negative predictive value of 44.85%. Conclusion: A clinical decision, matching patients who have no palpable veins and are older, with clinicians with greater confidence and experience, will likely improve FTIS.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherBMJ Publishing
dc.relation.ispartofpagefrom1
dc.relation.ispartofpageto10
dc.relation.ispartofissue4
dc.relation.ispartofjournalBMJ Open
dc.relation.ispartofvolume9
dc.subject.fieldofresearchBiomedical and clinical sciences
dc.subject.fieldofresearchClinical sciences
dc.subject.fieldofresearchOther health sciences
dc.subject.fieldofresearchcode32
dc.subject.fieldofresearchcode3202
dc.subject.fieldofresearchcode4299
dc.titleFactors associated with peripheral intravenous cannulation first-time insertion success in the emergency department. A multicentre prospective cohort analysis of patient, clinician and product characteristics
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
dcterms.licensehttp://creativecommons.org/licenses/by-nc/4.0/
dc.description.versionVersion of Record (VoR)
gro.rights.copyright© Author(s) 2019. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial.
gro.hasfulltextFull Text
gro.griffith.authorCooke, Marie L.


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