Pediatric Invasive Device Utility and Harm: Insights from a Multi-Site Survey
Introduction:
Invasive devices are indispensable in pediatric healthcare, yet they also pose significant risks. This multi-site point prevalence survey explores the utility and harm associated with invasive devices in hospitalized pediatric patients across three Australian tertiary hospitals.
Background:
Pediatric patients are particularly vulnerable to complications from invasive devices. Understanding the prevalence of device use and associated harm is crucial for improving patient safety and care quality in hospital settings.
Objective:
The study aimed to assess the prevalence of invasive devices, the rate of associated complications, and device failures in pediatric patients, offering insights into the need for better management strategies.
Methods:
Study Design: A multi-center, observational, rolling-point-prevalence survey conducted between 2022 and 2023.
Sampling: 50% of inpatients were systematically sampled by random allocation, and those with devices were followed for up to three days for device-related complications, failures, and management characteristics.
Key Findings:
1. Prevalence: Of the 285 patients audited, 78.2% had at least one invasive device, with a total of 412 devices in use. The median was 1 device per patient, with some patients having up to 13 devices.
2. Device Types: The most common devices were vascular access devices (54.1%), followed by gastrointestinal devices (27.2%).
3. Complications:
Day 0 Point-Prevalence: 10.7% of devices had complications.
Period-Prevalence: 27.7% of devices had complications throughout the audit period.
Device Failure: 13.4% of devices failed during the survey.
Conclusion:
The high prevalence of invasive devices and the significant rate of complications highlight the need for vigilant monitoring and improved strategies to minimize harm in pediatric hospital settings. The study emphasizes the importance of ongoing surveillance and the development of protocols to enhance the safety and efficacy of invasive device use in pediatric care.
Authors: Mari Takashima, Victoria Gibson, Eloise Borello, Lily Galluzzo, Fenella J. Gill, Sharon Kinney, Fiona Newall, Amanda J. Ullman
