The integrated short peripheral cannula: A new peripheral venous access device?

The effect of new device on pain and comfort levels in individuals undergoing peripheral intravenous cannula insertion

AIM AND OBJECTIVES

The purpose of this study is to see how ShotBlocker® affects the pain and comfort level associated with short peripheral intravenous cannula (PIV) insertion.

METHODS

The study was conducted on a single sample group using a pre-post design. Individuals in the sample group who underwent a brief PIV insertion procedure served as both the study's control and intervention groups. In the sample group, the same nurse inserted a peripheral intravenous catheter into the cephalic veins of the right and left forearms using a standard insertion and ShotBlocker®. The pain and comfort levels were assessed using the VAS and Comfort Scale.

RESULTS

When the distribution of the average pain and comfort scores of the individuals treated with the peripheral intravenous catheter was examined, it was found that the average pain score of the peripheral intravenous catheter insertion using ShotBlocker® was statistically significantly lower than the peripheral intravenous catheter insertion using the standard method, and the comfort score averages were statistically higher. When the correlation between the pain and comfort score averages of individuals undergoing peripheral intravenous catheter insertions was investigated, a statistically significant and strong negative relationship (p = 0.001) was discovered.

CONCLUSIONS

As a result, the use of ShotBlocker® during the short PIV insertion procedure is an effective method to reduce the pain caused by the peripheral intravenous catheter. It was determined that the comfort level of the individuals increased as the pain due to peripheral intravenous catheter insertion decreased.

Integrated short peripheral intravenous cannulas and risk of catheter failure: A systematic review and meta-analysis

BACKGROUND

Short peripheral catheters (SPCs) are used to provide intravenous therapies in hospitalized patients. Recently, the category of SPC has become more complex, with the introduction in clinical practice of "integrated" SPCs (ISPCs), renewed regarding the material (polyurethane rather than polytetrafluoroethylene) and design (large wing; pre-assembled extension; preassembled needle-free connector (NFC)).

METHODS

This systematic review and meta-analysis aimed to analyze randomized controlled trials (RCTs) and quasi-randomized studies in hospitalized patients, analyzing the risk of overall catheter failure as well as the risk of each type of complication (occlusion, infiltration, thrombophlebitis, and dislodgement) for ISPCs compared to non-integrated SPCs. These systematic review and meta-analysis were registered on PROSPERO (CRD42022322970).

DATA SOURCES

We searched PUBMED®, EMBASE®, and the Cochrane Controlled Clinical Trials register from April to November 2022.

RESULTS: INCLUDED STUDIES

The research identified 1260 articles. After the abstract review, 13 studies were included for full manuscript review and, after that, six papers (4727 patients) were included in the meta-analysis.

DESCRIPTION OF THE EFFECT

We found a significantly reduced risk of catheter failure (pooling all complications) for ISPCs compared to SPCs (p = 0.002 RR 0.65; 95% CI 0.63-0.9). A significant reduction in the risks of occlusion (p = 0.007 RR 0.72; 95% CI 0.56-0.92) was observed. As regards the risk of infiltration, thrombophlebitis, and dislodgement, the analysis showed a trend in favor of ISPCs, though not statistically significant (respectively p = 0.2 RR 0.84; 95% CI 0.64-1.1; p = 0.25 RR 0.91; 95% CI 0.78-1.07; p = 0.06 RR 0.72; 95% CI 0.52-1.01).

CONCLUSIONS

ISPCs significantly reduce the risks of catheter failure (overall complications) and occlusion. More RCTs are needed to understand if the preassembled ISPC is better than the composted closed system (non-integrated SPC + extension line + NFC).

Comparing successful insertions, dwell time, reinsertions and the costs of supplies between integrated and simple short peripheral catheters

BACKGROUND

Along with the challenges to strengthen patient safety in the use of short peripheral catheters (SPCs), various studies have been conducted in the past to explore differences between two main types of SPCs-integrated SPC (ISPC) and simple SPC (SSPC) in terms of clinical performance. The accumulated evidence from the literature lean toward the benefits of ISPC use in preventing complications leading to longer dwell time and more economical savings than SSPC use. The study aimed to compare ISPC and SSPC in terms of first-attempt successful insertions, number of attempts before successful insertion, perceived ease of insertion, dwell time, reinsertion rate, reasons for removal, and costs of supplies used for the insertions. Furthermore, it aimed to verify whether the previous results of referenced work in the use of ISPC were similar, and its use provided more foreseeable benefit for patient safety and cost-efficiency.

METHODS

This quasi-experimental study was conducted in a 650-bed tertiary academic medical center in the Philippines. Eligible participants were adult patients who were required SPC for at least 72 h by the physician. Using inferential statistics, comparisons were done among adult patients with integrated (n = 350) and simple (n = 350) SPC. Comparisons were also made according to insertion site and gauge of SPC.

RESULTS

The successful first-attempt insertions did not vary significantly at around 80% in both groups (p = 0.428). No significant differences were found in terms of attempts before successful insertion (p = 0.677), dwell time (p = 0.144), reinsertions (p = 0.934), and reasons for removal (p = 0.424). Meanwhile, comparable differences were noted in terms of perceived ease of insertion (p < 0.001) and cost of supplies used during the insertions (p < 0.001).

CONCLUSION

ISPCs can yield the same results with that of SSPCs while being easier to use and less costly.