Improving First-Time PIVC Insertion Success in Hospitalized Pediatric Patients

Peripheral intravenous catheters (PIVCs) are a critical part of pediatric care, but achieving first-time insertion success remains a challenge. Multiple failed attempts not only delay treatment but also increase complications, distress, and healthcare costs. A recent prospective cohort study explored the impact of patient characteristics, techniques, and technology on first-attempt PIVC insertion success in hospitalized children.

Study Overview
This study was conducted at a large quaternary pediatric hospital in Queensland, Australia, analyzing 199 children who required 250 PIVC insertions between July 2022 and September 2023. Researchers examined how factors such as clinician expertise, technology (e.g., ultrasound guidance), and patient demographics influenced first-time success rates.

Key Findings
Age and Weight Matter: Older children and those with higher body weight were more likely to have successful first-time insertions.
Prematurity Increases Risk: Children with a history of prematurity faced a higher likelihood of first-time insertion failure.
Vascular Access Specialists Improve Success Rates: Clinicians with specialized vascular access training had significantly higher success rates than general clinicians.
Ultrasound-Guided Insertions Yield Better Outcomes: The use of ultrasound technology greatly improved first-attempt success, especially for children with difficult venous access.

Clinical Implications
To improve first-time PIVC insertion success, hospitals should consider:
- Specialized training for vascular access teams to ensure more consistent and successful insertions.
- Integrating ultrasound guidance into routine pediatric PIVC procedures.
- Developing standardized protocols to optimize patient safety and reduce the need for multiple insertion attempts.

Conclusion
This study highlights the need for a multi-faceted approach combining expertise, technology, and standardized practices to enhance first-time PIVC insertion success. Implementing these strategies can significantly reduce patient distress, improve treatment efficiency, and enhance overall healthcare outcomes for pediatric patients.

Read more: https://onlinelibrary.wiley.com/doi/10.1111/jan.16795 

Authors: Tricia M. Kleidon, Mari Takashima, Claire M. Rickard, Jessica A. Schults, Andrew C. Bulmer, Amanda J. Ullman