Bridging the Gap in Traditional PIVC Placement: An Evaluation of Operation STICK Vascular Access Outcomes.

IF 2.8 3区医学 Q1 Pharmacology, Toxicology and Pharmaceutics

Therapeutics and Clinical Risk Management Pub Date : 2023-11-21 eCollection Date: 2023-01-01 DOI:10.2147/TCRM.S435628

Nicholas Mielke, Yuying Xing, Steven Matthew Gibson, Emily DiLoreto, Amit Bahl

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引用次数: 0

Abstract

Objective: Education and training is core to improving peripheral intravenous access outcomes. This study aimed to show that a vascular access training program (Operation STICK) in the emergency department (ED) improves the outcomes of traditionally placed peripheral intravenous catheters (PIVC).

Methods: This was a pre-post quasi-experimental study of traditionally placed PIVCs at a large ED in southeastern Michigan, United States. A control group (non-OSTICK) was compared to an experimental group (OSTICK) using a 3:1 propensity score matched analysis. Groups were comprised of ED patients with traditional PIVC placements in two separate six-month periods: non-OSTICK PIVCs from April to September 2021 and OSTICK PIVCs (placed by an OSTICK graduate) from October 2022 to March 2023. The primary outcome was PIVC functionality. The secondary outcome was adherence to best practices.

Results: A total of 6512 PIVCs were included in the study; 4884 (75.0%) were in the non-OSTICK group, while 1628 (25.0%) were in the OSTICK group. 68.1% of OSTICK PIVCs and 59.7% of non-OSTICK PIVCs were placed by ED technicians (p < 0.001). 91.3% of OSTICK PIVCs were placed on the first attempt, and 98.5% were placed within two attempts. A subgroup analysis of admitted patients (2540 PIVCs; 553 (21.8%) OSTICK-trained and 1987 (78.2%) non-OSTICK-trained) revealed 87.6% of OSTICK PIVCs and 80.3% of non-OSTICK PIVCs were 20 gauge (p < 0.001). The median proportion of dwell time to hospital length of stay was 94% for OSTICK PIVCs, compared to 88% for non-OSTICK PIVCs (p < 0.001).

Conclusion: This study underscores the value of education and training in enhancing vascular access outcomes. Implementing Operation STICK, a comprehensive vascular access training program, at a large ED has led to high first-stick success, adherence to best practice recommendations for site and device selection, and improved PIVC functionality for traditionally placed catheters.

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弥合传统PIVC置入的差距:粘连血管通路手术结果的评估。

目的:教育和培训是改善外周静脉通路结果的核心。本研究旨在表明急诊科(ED)的血管通路训练计划(Operation STICK)改善了传统放置外周静脉导管(PIVC)的结果。方法:这是一项在美国密歇根州东南部的一个大型急诊科传统放置pivc的准实验研究。采用3:1倾向评分匹配分析将对照组(非OSTICK)与实验组(OSTICK)进行比较。组由传统PIVC安置的ED患者组成，分为两个独立的六个月:2021年4月至9月的非OSTICK PIVC和2022年10月至2023年3月的OSTICK PIVC(由OSTICK毕业生安置)。主要结果是PIVC功能。次要结果是遵守最佳实践。结果:共纳入6512例pivc;非OSTICK组4884例(75.0%)，OSTICK组1628例(25.0%)。68.1%的OSTICK pivc和59.7%的非OSTICK pivc由ED技术人员放置(p < 0.001)。91.3%的ostik pivc是第一次置入的，98.5%是两次置入的。入院患者亚组分析(2540例pivc;553例(21.8%)受过ostik训练和1987例(78.2%)未受过ostik训练的pivc中，87.6%的ostik pivc和80.3%的非ostik pivc为20号(p < 0.001)。OSTICK pivc患者住院时间占住院时间的中位数比例为94%，而非OSTICK pivc患者为88% (p < 0.001)。结论:本研究强调了教育和培训在提高血管通路预后方面的价值。在大型急诊科实施Operation STICK，一项全面的血管通路培训计划，提高了首次粘连的成功率，坚持了地点和设备选择的最佳实践建议，并改善了传统放置导管的PIVC功能。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Therapeutics and Clinical Risk Management HEALTH CARE SCIENCES & SERVICES-

CiteScore

5.30

自引率

3.60%

发文量

139

审稿时长

16 weeks

期刊介绍： Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas. The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature. As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication. The journal does not accept study protocols, animal-based or cell line-based studies.