Extended intravenous catheter dwells to therapy completion.
Reducing needle sticks improve thalamus development.
Vessel preservation is a lifesaving strategy for neonates.
Pain reduction leads to better developmental outcomes.
Background: The use and efficacy of extended dwell peripheral intravenous catheters (EPIVs) has been extensively described at scientific conferences and in recent literature. The ramifications of repeated needle sticks include damage to vessels and ultimately the need for more invasive and costly access devices, which clearly support the need for reliable forms of vascular access.
Methods: This quality improvement project spanned 4 years, 2017 through 2020, and included 128 patients who required a peripherally inserted catheter as their primary or secondary access site for a prescribed therapy. The EPIV utilized was a 4-cm, 22-gauge catheter made of thermosensitive polyurethane inserted using the Seldinger technique.
Results: Over the course of 4 years, 128 patients received an EPIV for 2 or more days, totaling 849 days of therapy. Total insertion attempts were 174 or an average of 1.4 per patient. An estimated number of short PIVs needed for 849 days would have been 404 with 1011 attempts. Resultant savings with EPIV are estimated to be $30,686.
Conclusions: Reducing the number of patient peripheral intravenous attempts while extending the dwell time results in less patient trauma, reliable longer-term access, reduced infection risk, reduced supply usage, and savings in terms of nursing time. The ultimate result for preterm newborns is more efficient delivery of care with less cost.