Global pediatric peripheral intravenous catheter practice and performance: A secondary analysis of 4206 catheters
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Takashima, M
Kleidon, T
Ray-Barruel, G
Alexandrou, E
Rickard, CM
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Abstract
Purpose: To describe worldwide characteristics, performance and risk factors of peripheral intravenous catheters (PIVCs), in pediatrics. Design: A secondary, subgroup analysis of pediatric (<18 years) data was undertaken, using a global, cross-sectional study of PIVCs. Practice characteristics included: demographic, diagnostic, utility, management, performance and resources. Multivariate regression identified complication risks factors. Results: Data from 4206 children in 278 hospitals across 47 countries. Most PIVCs (outside of Australia, New Zealand) were inserted by nurses (71%; n = 2950), with dedicated teams only common in North America (23.2%; n = 85). Large gauges (≤18G) were mostly used in South America, Europe and Africa. Regions predominantly placed 24G (49%; n = 2060) except in Australia and New Zealand, who more commonly placed 22G (38.7%; n = 192). The most common placement was the hand (51%; n = 2143), however North America, Australia and New Zealand frequently utilised the antecubital fossa (24.5%, n = 90; 21.4%; n = 106). Polyurethane dressings were most used (67.1%; 2822), and many were not clean, dry and intact (17.1%; n = 715). Over 8% of PIVCs were idle, with the highest rates in North America (21.2%; n = 78). PIVC local complication risk factors included: >2 years age (odds ratio [OR] > 1.58; 1.2–2.1); ambulance/emergency insertion (OR 1.65; 1.2–2.3); upper arm/antecubital placement (OR 1.44; 1.1–2.0); poor dressing integrity (OR 5.4; 4.2–6.9); and 24–72 h dwell (OR > 1.9; 1.3–2.6). Conclusions: There is global inconsistency in pediatric PIVC practice, which may be causing harm. Clinical implications: Improvements in pediatric PIVC placement, dressings, and gauge selection are needed.
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Journal of Pediatric Nursing
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© 2019 Elsevier. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.
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Subject
Nursing
Catheterization
Evidence-based practice
Infection control
Pediatrics
Peripheral
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Ullman, AJ; Takashima, M; Kleidon, T; Ray-Barruel, G; Alexandrou, E; Rickard, CM, Global pediatric peripheral intravenous catheter practice and performance: A secondary analysis of 4206 catheters, Journal of Pediatric Nursing, 2019