dc.contributor.author | Carr, Peter J | |
dc.contributor.author | Rippey, James CR | |
dc.contributor.author | Cooke, Marie L | |
dc.contributor.author | Trevenen, Michelle L | |
dc.contributor.author | Higgins, Niall S | |
dc.contributor.author | Foale, Aileen S | |
dc.contributor.author | Rickard, Claire M | |
dc.date.accessioned | 2019-07-08T01:50:43Z | |
dc.date.available | 2019-07-08T01:50:43Z | |
dc.date.issued | 2019 | |
dc.identifier.issn | 2044-6055 | |
dc.identifier.doi | 10.1136/bmjopen-2018-022278 | |
dc.identifier.uri | http://hdl.handle.net/10072/386228 | |
dc.description.abstract | Objectives: 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.peerreviewed | Yes | |
dc.language | English | |
dc.language.iso | eng | |
dc.publisher | BMJ Publishing | |
dc.relation.ispartofpagefrom | 1 | |
dc.relation.ispartofpageto | 10 | |
dc.relation.ispartofissue | 4 | |
dc.relation.ispartofjournal | BMJ Open | |
dc.relation.ispartofvolume | 9 | |
dc.subject.fieldofresearch | Biomedical and clinical sciences | |
dc.subject.fieldofresearch | Clinical sciences | |
dc.subject.fieldofresearch | Other health sciences | |
dc.subject.fieldofresearchcode | 32 | |
dc.subject.fieldofresearchcode | 3202 | |
dc.subject.fieldofresearchcode | 4299 | |
dc.title | Factors 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.type | Journal article | |
dc.type.description | C1 - Articles | |
dc.type.code | C - Journal Articles | |
dcterms.license | http://creativecommons.org/licenses/by-nc/4.0/ | |
dc.description.version | Version 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.hasfulltext | Full Text | |
gro.griffith.author | Cooke, Marie L. | |