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Ray-Barruel G, Pather P, Schults JA, Rickard CM. Handheld Ultrasound Devices for Peripheral Intravenous Cannulation: A Scoping Review. JOURNAL OF INFUSION NURSING 2024; 47:75-95. [PMID: 38422403 DOI: 10.1097/nan.0000000000000540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Ultrasound-guided insertion of peripheral intravenous catheters (PIVCs) is recommended for patients with difficult intravenous access, but access to ultrasound equipment is often limited to specialty departments. Compact, affordable handheld ultrasound devices are available, but the extent of their clinical adoption and impact on patient outcomes is unknown. This scoping review aimed to explore evidence regarding handheld and pocket ultrasound devices for PIVC insertion. Databases were searched for studies published in English between January 2000 and January 2023 evaluating handheld or pocket ultrasound devices weighing ≤3 kg for PIVC insertion. Data were extracted using standardized forms and summarized using descriptive statistics. Seventeen studies reporting the use of handheld or pocket ultrasound devices were identified. Most studies were conducted in adult inpatient facilities; 3 included pediatrics, and 2 reported out-of-hospital use. Participants with difficult intravenous access featured in 9 studies. Ultrasound training programs were described in 12 studies, with competency defined by number of successful PIVC insertions. Five studies reported clinician and/or patient perspectives. Ultrasound for PIVC insertion is not widely accessible in nonspecialist areas, but more compact and affordable handheld models could provide a solution, especially for patients with difficult access. More research evidence using handheld ultrasound is needed.
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Affiliation(s)
- Gillian Ray-Barruel
- School of Nursing, Midwifery and Social Work, University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia (Ray-Barruel, Schults, Rickard); Herston Infectious Diseases Institute and Metro North Hospital and Health Service, Brisbane, Queensland, Australia (Ray-Barruel, Schults, Rickard); Alliance for Vascular Access Teaching and Research, School of Nursing and Midwifery and Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia (Ray-Barruel, Pather, Schults, Rickard); ICU Outreach, QEII Jubilee Hospital, Coopers Plains, Queensland, Australia (Pather); Department of Anaesthesia and Pain Management, Queensland Children's Hospital, Brisbane, Queensland, Australia (Schults)
- Gillian Ray-Barruel, PhD, RN, is a senior research fellow with the University of Queensland School of Nursing, Midwifery and Social Work and the Herston Infectious Diseases Institute (HeIDI), as well as an adjunct senior research fellow with Griffith University in Brisbane, Australia. She is also education director with the Alliance for Vascular Access Teaching and Research (AVATAR) and associate editor for the ACIPC journal Infection, Disease & Health. Following a successful 20-year career in critical care nursing and project management, Dr Ray-Barruel established her career as an internationally respected nurse researcher with over 70 peer-reviewed publications. Her research focuses on improving assessment and decision-making by bedside clinicians to prevent device-related patient complications and improve health care outcomes
- Priscilla Pather, RN, MAppSc (Research), is an emerging early career researcher and a clinical nurse consultant working with ICU Outreach at Queen Elizabeth II Jubilee Hospital, Brisbane, and a registered intensive care unit (ICU) nurse at Mater Health Services, South Brisbane. As a front-line clinician focused on early detection and management of the deteriorating patient, she has strong cannulation skills and is ideally placed between academia and clinical settings to conduct research and audits, as well as to promote and monitor developments in this field. She is invested in safety and quality, adopting evidence-based practice into clinical care to promote and preserve vessel health
- Jessica Schults, PhD, RN, is a conjoint senior research fellow with The University of Queensland School of Nursing, Midwifery and Social Work and Metro North's Herston Infectious Disease Institute. Her research themes to date have focused on ventilation strategies to reduce ventilator-associated pneumonia and interventions to improve the safety and quality of care related to invasive medical devices. Dr Schults's developing research themes focus on enhancing health service surveillance using electronic health information in 2 major spheres: hospital-level surveillance for hospital-acquired complications and unit-level surveillance for vascular access device complications and ventilator-associated events. She is particularly interested in advances in infectious disease surveillance and tracking, using a combination of mature platforms and new electronic platforms
- Claire M. Rickard, PhD, RN, is professor of infection prevention and vascular access at the University of Queensland and Metro North Health in Brisbane, Australia. She is also adjunct professor with Griffith University and board cochair of the Australian and New Zealand Intensive Care Foundation. She established and coleads the Alliance for Vascular Access Teaching and Research (avatargroup.org.au), a large collaborative with the vision to "make vascular access complications history." Her background is in critical care and med-surg nursing followed by a focus on clinical research leading to >300 publications, including 45 randomized controlled trials. She was recognized in the International Nurse Researcher Hall of Fame in 2013, and elected to the Australian Academy of Health and Medical Sciences in 2015 and the American Academy of Nursing in 2021
| | - Priscilla Pather
- School of Nursing, Midwifery and Social Work, University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia (Ray-Barruel, Schults, Rickard); Herston Infectious Diseases Institute and Metro North Hospital and Health Service, Brisbane, Queensland, Australia (Ray-Barruel, Schults, Rickard); Alliance for Vascular Access Teaching and Research, School of Nursing and Midwifery and Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia (Ray-Barruel, Pather, Schults, Rickard); ICU Outreach, QEII Jubilee Hospital, Coopers Plains, Queensland, Australia (Pather); Department of Anaesthesia and Pain Management, Queensland Children's Hospital, Brisbane, Queensland, Australia (Schults)
- Gillian Ray-Barruel, PhD, RN, is a senior research fellow with the University of Queensland School of Nursing, Midwifery and Social Work and the Herston Infectious Diseases Institute (HeIDI), as well as an adjunct senior research fellow with Griffith University in Brisbane, Australia. She is also education director with the Alliance for Vascular Access Teaching and Research (AVATAR) and associate editor for the ACIPC journal Infection, Disease & Health. Following a successful 20-year career in critical care nursing and project management, Dr Ray-Barruel established her career as an internationally respected nurse researcher with over 70 peer-reviewed publications. Her research focuses on improving assessment and decision-making by bedside clinicians to prevent device-related patient complications and improve health care outcomes
- Priscilla Pather, RN, MAppSc (Research), is an emerging early career researcher and a clinical nurse consultant working with ICU Outreach at Queen Elizabeth II Jubilee Hospital, Brisbane, and a registered intensive care unit (ICU) nurse at Mater Health Services, South Brisbane. As a front-line clinician focused on early detection and management of the deteriorating patient, she has strong cannulation skills and is ideally placed between academia and clinical settings to conduct research and audits, as well as to promote and monitor developments in this field. She is invested in safety and quality, adopting evidence-based practice into clinical care to promote and preserve vessel health
- Jessica Schults, PhD, RN, is a conjoint senior research fellow with The University of Queensland School of Nursing, Midwifery and Social Work and Metro North's Herston Infectious Disease Institute. Her research themes to date have focused on ventilation strategies to reduce ventilator-associated pneumonia and interventions to improve the safety and quality of care related to invasive medical devices. Dr Schults's developing research themes focus on enhancing health service surveillance using electronic health information in 2 major spheres: hospital-level surveillance for hospital-acquired complications and unit-level surveillance for vascular access device complications and ventilator-associated events. She is particularly interested in advances in infectious disease surveillance and tracking, using a combination of mature platforms and new electronic platforms
- Claire M. Rickard, PhD, RN, is professor of infection prevention and vascular access at the University of Queensland and Metro North Health in Brisbane, Australia. She is also adjunct professor with Griffith University and board cochair of the Australian and New Zealand Intensive Care Foundation. She established and coleads the Alliance for Vascular Access Teaching and Research (avatargroup.org.au), a large collaborative with the vision to "make vascular access complications history." Her background is in critical care and med-surg nursing followed by a focus on clinical research leading to >300 publications, including 45 randomized controlled trials. She was recognized in the International Nurse Researcher Hall of Fame in 2013, and elected to the Australian Academy of Health and Medical Sciences in 2015 and the American Academy of Nursing in 2021
| | - Jessica A Schults
- School of Nursing, Midwifery and Social Work, University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia (Ray-Barruel, Schults, Rickard); Herston Infectious Diseases Institute and Metro North Hospital and Health Service, Brisbane, Queensland, Australia (Ray-Barruel, Schults, Rickard); Alliance for Vascular Access Teaching and Research, School of Nursing and Midwifery and Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia (Ray-Barruel, Pather, Schults, Rickard); ICU Outreach, QEII Jubilee Hospital, Coopers Plains, Queensland, Australia (Pather); Department of Anaesthesia and Pain Management, Queensland Children's Hospital, Brisbane, Queensland, Australia (Schults)
- Gillian Ray-Barruel, PhD, RN, is a senior research fellow with the University of Queensland School of Nursing, Midwifery and Social Work and the Herston Infectious Diseases Institute (HeIDI), as well as an adjunct senior research fellow with Griffith University in Brisbane, Australia. She is also education director with the Alliance for Vascular Access Teaching and Research (AVATAR) and associate editor for the ACIPC journal Infection, Disease & Health. Following a successful 20-year career in critical care nursing and project management, Dr Ray-Barruel established her career as an internationally respected nurse researcher with over 70 peer-reviewed publications. Her research focuses on improving assessment and decision-making by bedside clinicians to prevent device-related patient complications and improve health care outcomes
- Priscilla Pather, RN, MAppSc (Research), is an emerging early career researcher and a clinical nurse consultant working with ICU Outreach at Queen Elizabeth II Jubilee Hospital, Brisbane, and a registered intensive care unit (ICU) nurse at Mater Health Services, South Brisbane. As a front-line clinician focused on early detection and management of the deteriorating patient, she has strong cannulation skills and is ideally placed between academia and clinical settings to conduct research and audits, as well as to promote and monitor developments in this field. She is invested in safety and quality, adopting evidence-based practice into clinical care to promote and preserve vessel health
- Jessica Schults, PhD, RN, is a conjoint senior research fellow with The University of Queensland School of Nursing, Midwifery and Social Work and Metro North's Herston Infectious Disease Institute. Her research themes to date have focused on ventilation strategies to reduce ventilator-associated pneumonia and interventions to improve the safety and quality of care related to invasive medical devices. Dr Schults's developing research themes focus on enhancing health service surveillance using electronic health information in 2 major spheres: hospital-level surveillance for hospital-acquired complications and unit-level surveillance for vascular access device complications and ventilator-associated events. She is particularly interested in advances in infectious disease surveillance and tracking, using a combination of mature platforms and new electronic platforms
- Claire M. Rickard, PhD, RN, is professor of infection prevention and vascular access at the University of Queensland and Metro North Health in Brisbane, Australia. She is also adjunct professor with Griffith University and board cochair of the Australian and New Zealand Intensive Care Foundation. She established and coleads the Alliance for Vascular Access Teaching and Research (avatargroup.org.au), a large collaborative with the vision to "make vascular access complications history." Her background is in critical care and med-surg nursing followed by a focus on clinical research leading to >300 publications, including 45 randomized controlled trials. She was recognized in the International Nurse Researcher Hall of Fame in 2013, and elected to the Australian Academy of Health and Medical Sciences in 2015 and the American Academy of Nursing in 2021
| | - Claire M Rickard
- School of Nursing, Midwifery and Social Work, University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia (Ray-Barruel, Schults, Rickard); Herston Infectious Diseases Institute and Metro North Hospital and Health Service, Brisbane, Queensland, Australia (Ray-Barruel, Schults, Rickard); Alliance for Vascular Access Teaching and Research, School of Nursing and Midwifery and Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia (Ray-Barruel, Pather, Schults, Rickard); ICU Outreach, QEII Jubilee Hospital, Coopers Plains, Queensland, Australia (Pather); Department of Anaesthesia and Pain Management, Queensland Children's Hospital, Brisbane, Queensland, Australia (Schults)
- Gillian Ray-Barruel, PhD, RN, is a senior research fellow with the University of Queensland School of Nursing, Midwifery and Social Work and the Herston Infectious Diseases Institute (HeIDI), as well as an adjunct senior research fellow with Griffith University in Brisbane, Australia. She is also education director with the Alliance for Vascular Access Teaching and Research (AVATAR) and associate editor for the ACIPC journal Infection, Disease & Health. Following a successful 20-year career in critical care nursing and project management, Dr Ray-Barruel established her career as an internationally respected nurse researcher with over 70 peer-reviewed publications. Her research focuses on improving assessment and decision-making by bedside clinicians to prevent device-related patient complications and improve health care outcomes
- Priscilla Pather, RN, MAppSc (Research), is an emerging early career researcher and a clinical nurse consultant working with ICU Outreach at Queen Elizabeth II Jubilee Hospital, Brisbane, and a registered intensive care unit (ICU) nurse at Mater Health Services, South Brisbane. As a front-line clinician focused on early detection and management of the deteriorating patient, she has strong cannulation skills and is ideally placed between academia and clinical settings to conduct research and audits, as well as to promote and monitor developments in this field. She is invested in safety and quality, adopting evidence-based practice into clinical care to promote and preserve vessel health
- Jessica Schults, PhD, RN, is a conjoint senior research fellow with The University of Queensland School of Nursing, Midwifery and Social Work and Metro North's Herston Infectious Disease Institute. Her research themes to date have focused on ventilation strategies to reduce ventilator-associated pneumonia and interventions to improve the safety and quality of care related to invasive medical devices. Dr Schults's developing research themes focus on enhancing health service surveillance using electronic health information in 2 major spheres: hospital-level surveillance for hospital-acquired complications and unit-level surveillance for vascular access device complications and ventilator-associated events. She is particularly interested in advances in infectious disease surveillance and tracking, using a combination of mature platforms and new electronic platforms
- Claire M. Rickard, PhD, RN, is professor of infection prevention and vascular access at the University of Queensland and Metro North Health in Brisbane, Australia. She is also adjunct professor with Griffith University and board cochair of the Australian and New Zealand Intensive Care Foundation. She established and coleads the Alliance for Vascular Access Teaching and Research (avatargroup.org.au), a large collaborative with the vision to "make vascular access complications history." Her background is in critical care and med-surg nursing followed by a focus on clinical research leading to >300 publications, including 45 randomized controlled trials. She was recognized in the International Nurse Researcher Hall of Fame in 2013, and elected to the Australian Academy of Health and Medical Sciences in 2015 and the American Academy of Nursing in 2021
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Bahl A, Alsbrooks K, Zazyczny KA, Johnson S, Hoerauf K. An Improved Definition and SAFE Rule for Predicting Difficult Intravascular Access (DIVA) in Hospitalized Adults. JOURNAL OF INFUSION NURSING 2024; 47:96-107. [PMID: 38377305 PMCID: PMC10913859 DOI: 10.1097/nan.0000000000000535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Patients with difficult intravascular access (DIVA) are common, yet the condition is often ignored or poorly managed, leading to patient dissatisfaction and misuse of health care resources. This study sought to assess all published risk factors associated with DIVA in order to promote prospective identification and improved management of patients with DIVA. A systematic literature review on risk factors associated with DIVA was conducted. Risk factors published in ≥4 eligible studies underwent a multivariate meta-analysis of multiple factors (MVMA-MF) using the Bayesian framework. Of 2535 unique publications identified, 20 studies were eligible for review. In total, 82 unique DIVA risk factors were identified, with the 10 factors found in ≥4 studies undergoing MVMA-MF. Significant predictors of DIVA included vein visibility, vein palpability, history of DIVA, obesity (body mass index [BMI] >30), and history of intravenous (IV) drug abuse, which were combined to create the mnemonic guideline, SAFE: See, Ask (about a history of DIVA or IV drug abuse), Feel, and Evaluate BMI. By recognizing patients with DIVA before the first insertion attempt and treating them from the outset with advanced vein visualization techniques, patients with DIVA could be subject to less frequent painful venipunctures, fewer delays in treatment, and a reduction in other DIVA-associated burdens.
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Affiliation(s)
- Amit Bahl
- Emergency Medicine, Beaumont Hospital, Royal Oak, Michigan (Bahl and Johnson), Becton Dickinson and Co, Franklin Lakes, New Jersey (Alsbrooks and Hoerauf), and Bryn Mawr Hospital, Bryn Mawr, Pennsylvania (Zazyczny)
- Amit Bahl, MD, is a physician scientist with board certification in emergency medicine and subspeciality expertise in point-of-care ultrasound. He is the recipient of several foundation and industry grants for research and has authored numerous peer-reviewed manuscripts in high-impact medical journals. Dr Bahl is a passionate speaker who presents internationally on the complications of vascular access devices and strategies to improve patient outcomes
- Kim Alsbrooks has over 30 years of experience in the medical field. She started as a Radiologic Technologist then Registered Nurse, working on specialized hospital teams in Oncology and Vascular Access. She has worked at BARD/Becton, Dickinson, and Company, where she is now the Sr Director of Medical Affairs, for the past 20 years. Her work is mostly focused on vascular access evidence generation and research. Kim speaks across the US and internationally on vascular access topics
- Kelly Ann Zazyczny, BSN, RN, RT (R), VA-BC, is the director of nursing of the Psychiatric, Women, and Children's Division at Bryn Mawr Hospital, Vascular Access Nursing Services for the Main Line Health System. She has been a clinical leader for over 25 years, holding positions at Main Line Health, The Children's Hospital of Philadelphia, and Children's Healthcare of Atlanta. Her clinical focus has been on pediatrics, vascular access, radiology, and research. She has been named one of the Top Nurses in Nursing Management by Main Line Today for the last 3 years
- Steven Johnson, DO, is a board-certified emergency medicine physician and critical care fellow at the University of Southern California. He also conducts catheter-related research in his work as a research scientist at Beaumont Health. He developed a passion for improving peripheral venous access after witnessing firsthand how poor catheter performance affects patient outcomes and overall health
- Klaus Hoerauf, MD, PhD, currently serves as worldwide vice president of medical affairs, medication delivery solutions, at Becton, Dickinson, and Company. In this role, he leads Medical & Scientific Affairs and Health Economics and Outcomes Research departments. He has an MD and a Doctorate in Cardiology from the Medical University of Münster and has been appointed as associate professor of anesthesiology and intensive care medicine at the Medical University of Vienna, Austria. He is certified in anesthesiology and intensive care medicine, emergency medicine, and pain therapy
| | - Kimberly Alsbrooks
- Corresponding Author: Kimberly Alsbrooks, BSN, RN, RT (R), VA-BC, Becton Dickinson and Company, 18-03 NJ-208, Franklin Lakes, NJ, USA 07417 ()
| | - Kelly Ann Zazyczny
- Emergency Medicine, Beaumont Hospital, Royal Oak, Michigan (Bahl and Johnson), Becton Dickinson and Co, Franklin Lakes, New Jersey (Alsbrooks and Hoerauf), and Bryn Mawr Hospital, Bryn Mawr, Pennsylvania (Zazyczny)
- Amit Bahl, MD, is a physician scientist with board certification in emergency medicine and subspeciality expertise in point-of-care ultrasound. He is the recipient of several foundation and industry grants for research and has authored numerous peer-reviewed manuscripts in high-impact medical journals. Dr Bahl is a passionate speaker who presents internationally on the complications of vascular access devices and strategies to improve patient outcomes
- Kim Alsbrooks has over 30 years of experience in the medical field. She started as a Radiologic Technologist then Registered Nurse, working on specialized hospital teams in Oncology and Vascular Access. She has worked at BARD/Becton, Dickinson, and Company, where she is now the Sr Director of Medical Affairs, for the past 20 years. Her work is mostly focused on vascular access evidence generation and research. Kim speaks across the US and internationally on vascular access topics
- Kelly Ann Zazyczny, BSN, RN, RT (R), VA-BC, is the director of nursing of the Psychiatric, Women, and Children's Division at Bryn Mawr Hospital, Vascular Access Nursing Services for the Main Line Health System. She has been a clinical leader for over 25 years, holding positions at Main Line Health, The Children's Hospital of Philadelphia, and Children's Healthcare of Atlanta. Her clinical focus has been on pediatrics, vascular access, radiology, and research. She has been named one of the Top Nurses in Nursing Management by Main Line Today for the last 3 years
- Steven Johnson, DO, is a board-certified emergency medicine physician and critical care fellow at the University of Southern California. He also conducts catheter-related research in his work as a research scientist at Beaumont Health. He developed a passion for improving peripheral venous access after witnessing firsthand how poor catheter performance affects patient outcomes and overall health
- Klaus Hoerauf, MD, PhD, currently serves as worldwide vice president of medical affairs, medication delivery solutions, at Becton, Dickinson, and Company. In this role, he leads Medical & Scientific Affairs and Health Economics and Outcomes Research departments. He has an MD and a Doctorate in Cardiology from the Medical University of Münster and has been appointed as associate professor of anesthesiology and intensive care medicine at the Medical University of Vienna, Austria. He is certified in anesthesiology and intensive care medicine, emergency medicine, and pain therapy
| | - Steven Johnson
- Emergency Medicine, Beaumont Hospital, Royal Oak, Michigan (Bahl and Johnson), Becton Dickinson and Co, Franklin Lakes, New Jersey (Alsbrooks and Hoerauf), and Bryn Mawr Hospital, Bryn Mawr, Pennsylvania (Zazyczny)
- Amit Bahl, MD, is a physician scientist with board certification in emergency medicine and subspeciality expertise in point-of-care ultrasound. He is the recipient of several foundation and industry grants for research and has authored numerous peer-reviewed manuscripts in high-impact medical journals. Dr Bahl is a passionate speaker who presents internationally on the complications of vascular access devices and strategies to improve patient outcomes
- Kim Alsbrooks has over 30 years of experience in the medical field. She started as a Radiologic Technologist then Registered Nurse, working on specialized hospital teams in Oncology and Vascular Access. She has worked at BARD/Becton, Dickinson, and Company, where she is now the Sr Director of Medical Affairs, for the past 20 years. Her work is mostly focused on vascular access evidence generation and research. Kim speaks across the US and internationally on vascular access topics
- Kelly Ann Zazyczny, BSN, RN, RT (R), VA-BC, is the director of nursing of the Psychiatric, Women, and Children's Division at Bryn Mawr Hospital, Vascular Access Nursing Services for the Main Line Health System. She has been a clinical leader for over 25 years, holding positions at Main Line Health, The Children's Hospital of Philadelphia, and Children's Healthcare of Atlanta. Her clinical focus has been on pediatrics, vascular access, radiology, and research. She has been named one of the Top Nurses in Nursing Management by Main Line Today for the last 3 years
- Steven Johnson, DO, is a board-certified emergency medicine physician and critical care fellow at the University of Southern California. He also conducts catheter-related research in his work as a research scientist at Beaumont Health. He developed a passion for improving peripheral venous access after witnessing firsthand how poor catheter performance affects patient outcomes and overall health
- Klaus Hoerauf, MD, PhD, currently serves as worldwide vice president of medical affairs, medication delivery solutions, at Becton, Dickinson, and Company. In this role, he leads Medical & Scientific Affairs and Health Economics and Outcomes Research departments. He has an MD and a Doctorate in Cardiology from the Medical University of Münster and has been appointed as associate professor of anesthesiology and intensive care medicine at the Medical University of Vienna, Austria. He is certified in anesthesiology and intensive care medicine, emergency medicine, and pain therapy
| | - Klaus Hoerauf
- Emergency Medicine, Beaumont Hospital, Royal Oak, Michigan (Bahl and Johnson), Becton Dickinson and Co, Franklin Lakes, New Jersey (Alsbrooks and Hoerauf), and Bryn Mawr Hospital, Bryn Mawr, Pennsylvania (Zazyczny)
- Amit Bahl, MD, is a physician scientist with board certification in emergency medicine and subspeciality expertise in point-of-care ultrasound. He is the recipient of several foundation and industry grants for research and has authored numerous peer-reviewed manuscripts in high-impact medical journals. Dr Bahl is a passionate speaker who presents internationally on the complications of vascular access devices and strategies to improve patient outcomes
- Kim Alsbrooks has over 30 years of experience in the medical field. She started as a Radiologic Technologist then Registered Nurse, working on specialized hospital teams in Oncology and Vascular Access. She has worked at BARD/Becton, Dickinson, and Company, where she is now the Sr Director of Medical Affairs, for the past 20 years. Her work is mostly focused on vascular access evidence generation and research. Kim speaks across the US and internationally on vascular access topics
- Kelly Ann Zazyczny, BSN, RN, RT (R), VA-BC, is the director of nursing of the Psychiatric, Women, and Children's Division at Bryn Mawr Hospital, Vascular Access Nursing Services for the Main Line Health System. She has been a clinical leader for over 25 years, holding positions at Main Line Health, The Children's Hospital of Philadelphia, and Children's Healthcare of Atlanta. Her clinical focus has been on pediatrics, vascular access, radiology, and research. She has been named one of the Top Nurses in Nursing Management by Main Line Today for the last 3 years
- Steven Johnson, DO, is a board-certified emergency medicine physician and critical care fellow at the University of Southern California. He also conducts catheter-related research in his work as a research scientist at Beaumont Health. He developed a passion for improving peripheral venous access after witnessing firsthand how poor catheter performance affects patient outcomes and overall health
- Klaus Hoerauf, MD, PhD, currently serves as worldwide vice president of medical affairs, medication delivery solutions, at Becton, Dickinson, and Company. In this role, he leads Medical & Scientific Affairs and Health Economics and Outcomes Research departments. He has an MD and a Doctorate in Cardiology from the Medical University of Münster and has been appointed as associate professor of anesthesiology and intensive care medicine at the Medical University of Vienna, Austria. He is certified in anesthesiology and intensive care medicine, emergency medicine, and pain therapy
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Abe-Doi M, Murayama R, Morita K, Nakagami G, Sanada H. Predictive Factors for Infusion Site Induration After Outpatient Chemotherapy in Japan: A Secondary Analysis. Asian Nurs Res (Korean Soc Nurs Sci) 2023; 17:269-275. [PMID: 38101470 DOI: 10.1016/j.anr.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 11/21/2023] [Accepted: 11/21/2023] [Indexed: 12/17/2023] Open
Abstract
PURPOSE Even in the absence of extravasation, some patients develop induration at the peripheral intravenous catheterization site prior to the next day's treatment. Infusion site induration commonly affects patients who undergo repeated chemotherapy administrations. Vessel health is crucial for the continuation of chemotherapy. However, there is no effective method to prevent induration. Hence, this study aimed to investigate the factors that could cause induration for preventing its occurrence. METHODS This study was a secondary analysis of a prospective observational study. All participants were undergoing outpatient chemotherapy. Participant characteristics and related catheterization data were collected on the treatment day as baseline, and induration incidence was recorded on the subsequent treatment day. Receiver operating characteristic (ROC) analysis was performed to determine the sensitivity and specificity of cutoff points of the vein and catheter diameter ratios for distinguishing between developed induration and not developed induration. Additionally, cox regression analysis with multiple imputation was used to investigate the factors that predicted induration. RESULTS Seventy-one patients participated in the study. The cutoff point of the vein/catheter diameter ratio calculated using ROC analysis was ≥3.7. The ratio of larger-diameter veins to catheter diameter of ≥3.7 times was negatively associated with induration in both complete case analysis (HR: 0.11; p = 0.034) and multiple imputation analysis (HR: 0.12; p = .049). CONCLUSIONS Selecting the vein with 3.7 times higher diameter than the catheter diameter for the catheterization site may help prevent induration on the next treatment day.
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Affiliation(s)
- Mari Abe-Doi
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Ryoko Murayama
- Research Center for Implementation Nursing Science Initiative, Research Promotion Headquarters, Fujita Health University, Aichi, Japan
| | - Kojiro Morita
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Gojiro Nakagami
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hiromi Sanada
- Department of Nursing, Ishikawa Prefectural Nursing University, Ishikawa, Japan.
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