Paramedic insertion of peripheral intravenous catheters, unused catheter rates, and influencing factors: A retrospective review.
Ambulance
Emergency medical technicians
Vascular access device
Journal
American journal of infection control
ISSN: 1527-3296
Titre abrégé: Am J Infect Control
Pays: United States
ID NLM: 8004854
Informations de publication
Date de publication:
12 2023
12 2023
Historique:
received:
13
10
2022
revised:
10
05
2023
accepted:
10
05
2023
medline:
20
11
2023
pubmed:
19
5
2023
entrez:
18
5
2023
Statut:
ppublish
Résumé
Peripheral intravenous catheters (PIVCs) are associated with adverse events such as bloodstream infections; thus clinically appropriate practice is important. However, there is limited research on PIVC use in ambulance settings. This study investigated the incidence of paramedic-inserted PIVCs, unused PIVCs, and factors that influenced practice. Electronic patient care records for Western Australian ambulance service patients who attended between January 1 and December 31, 2020 were retrospectively reviewed. Patient, environmental, and paramedic characteristics were explored. Binominal logistical regression models were used to identify factors associated with PIVC insertion and unused PIVCs. A total of 187,585 records were included; 20.3% had a PIVC inserted and 44% remained unused. Factors associated with PIVC insertion were gender, age, problem urgency, chief complaint, and operational region. Age, chief complaint, and paramedic years of experience were associated with unused PIVCs. This study identified multiple modifiable factors for the unnecessary insertion of PIVCs, which may be addressed through better education and mentoring of paramedics supported by clearer clinical guidelines. This is, to our knowledge, the first Australian state-wide study to report unused paramedic-inserted PIVC rates. As 44% remained unused, clinical indication guidelines and intervention studies to reduce PIVC insertion are warranted.
Sections du résumé
BACKGROUND
Peripheral intravenous catheters (PIVCs) are associated with adverse events such as bloodstream infections; thus clinically appropriate practice is important. However, there is limited research on PIVC use in ambulance settings. This study investigated the incidence of paramedic-inserted PIVCs, unused PIVCs, and factors that influenced practice.
METHODS
Electronic patient care records for Western Australian ambulance service patients who attended between January 1 and December 31, 2020 were retrospectively reviewed. Patient, environmental, and paramedic characteristics were explored. Binominal logistical regression models were used to identify factors associated with PIVC insertion and unused PIVCs.
RESULTS
A total of 187,585 records were included; 20.3% had a PIVC inserted and 44% remained unused. Factors associated with PIVC insertion were gender, age, problem urgency, chief complaint, and operational region. Age, chief complaint, and paramedic years of experience were associated with unused PIVCs.
DISCUSSION
This study identified multiple modifiable factors for the unnecessary insertion of PIVCs, which may be addressed through better education and mentoring of paramedics supported by clearer clinical guidelines.
CONCLUSIONS
This is, to our knowledge, the first Australian state-wide study to report unused paramedic-inserted PIVC rates. As 44% remained unused, clinical indication guidelines and intervention studies to reduce PIVC insertion are warranted.
Identifiants
pubmed: 37201643
pii: S0196-6553(23)00364-4
doi: 10.1016/j.ajic.2023.05.007
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1411-1416Informations de copyright
Copyright © 2023 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.