Andrew Callahan, Maya Shamailov, Kim Kalo, James F Bena, Shannon L Morrison, Jane Hartman, Nancy M Albert
{"title":"住院外科成人静脉注射第一次尝试和总体成功相关因素的多变量分析","authors":"Andrew Callahan, Maya Shamailov, Kim Kalo, James F Bena, Shannon L Morrison, Jane Hartman, Nancy M Albert","doi":"10.1111/jocn.17604","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>To determine patient and nursing factors associated with peripheral intravenous access success among hospitalised adults on medical-surgical units.</p><p><strong>Design: </strong>A prospective, cross-sectional, correlational design was guided by STROBE.</p><p><strong>Methods: </strong>Within a quaternary care hospital with multiple medical-surgical units, nurses who attempted intravenous access completed case report forms and medical records were reviewed to record 38 factors associated with intravenous access success. After identifying factors associated with first attempt and overall intravenous access success in univariate analyses, prediction models were fit and calibration (based on plots) and discrimination (using the C-statistic) were evaluated using bootstrap sampling.</p><p><strong>Results: </strong>Of 394 adults, 244 (61.9%) had first attempt and 323 (82.0%) had overall intravenous access success. Ultrasound was used in 227 (57.6%) intravenous access attempts and use was associated with less vein visibility and palpability and higher nurse perception of difficult intravenous access. In multivariable modelling, four factors were associated with first attempt intravenous access success: using a wrist vein, higher nurse expertise in intravenous access, nurse use of an ultrasound in patients with high-risk vein characteristics, and higher nurse confidence in first attempt success; model goodness of fit was good. Seven factors were associated with overall intravenous access success: shorter patient hospital length of stay, no history of diabetes, higher patient anxiety level, nurse use of an ultrasound in patients with high-risk vein characteristics, higher nurse expertise in intravenous access, higher nurse confidence in first attempt success, and nurse prediction of difficult intravenous access was low; model goodness of fit was strong.</p><p><strong>Conclusion: </strong>Patients' vein characteristics and nurses' confidence in first attempt intravenous access success were predominant characteristics of intravenous access success.</p><p><strong>Implications: </strong>Factors of importance in achieving intravenous access can be easily assessed prior to first attempt and may enhance first attempt and overall success.</p><p><strong>Reporting method: </strong>Authors adhered to relevant EQUATOR guidelines and used the following reporting method: STROBE (The Strengthening the Reporting of Observational Studies).</p>","PeriodicalId":50236,"journal":{"name":"Journal of Clinical Nursing","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Multivariable Analysis of Factors Associated With Intravenous Access First Attempt and Overall Success in Hospitalised Medical-Surgical Adults.\",\"authors\":\"Andrew Callahan, Maya Shamailov, Kim Kalo, James F Bena, Shannon L Morrison, Jane Hartman, Nancy M Albert\",\"doi\":\"10.1111/jocn.17604\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>To determine patient and nursing factors associated with peripheral intravenous access success among hospitalised adults on medical-surgical units.</p><p><strong>Design: </strong>A prospective, cross-sectional, correlational design was guided by STROBE.</p><p><strong>Methods: </strong>Within a quaternary care hospital with multiple medical-surgical units, nurses who attempted intravenous access completed case report forms and medical records were reviewed to record 38 factors associated with intravenous access success. After identifying factors associated with first attempt and overall intravenous access success in univariate analyses, prediction models were fit and calibration (based on plots) and discrimination (using the C-statistic) were evaluated using bootstrap sampling.</p><p><strong>Results: </strong>Of 394 adults, 244 (61.9%) had first attempt and 323 (82.0%) had overall intravenous access success. Ultrasound was used in 227 (57.6%) intravenous access attempts and use was associated with less vein visibility and palpability and higher nurse perception of difficult intravenous access. In multivariable modelling, four factors were associated with first attempt intravenous access success: using a wrist vein, higher nurse expertise in intravenous access, nurse use of an ultrasound in patients with high-risk vein characteristics, and higher nurse confidence in first attempt success; model goodness of fit was good. Seven factors were associated with overall intravenous access success: shorter patient hospital length of stay, no history of diabetes, higher patient anxiety level, nurse use of an ultrasound in patients with high-risk vein characteristics, higher nurse expertise in intravenous access, higher nurse confidence in first attempt success, and nurse prediction of difficult intravenous access was low; model goodness of fit was strong.</p><p><strong>Conclusion: </strong>Patients' vein characteristics and nurses' confidence in first attempt intravenous access success were predominant characteristics of intravenous access success.</p><p><strong>Implications: </strong>Factors of importance in achieving intravenous access can be easily assessed prior to first attempt and may enhance first attempt and overall success.</p><p><strong>Reporting method: </strong>Authors adhered to relevant EQUATOR guidelines and used the following reporting method: STROBE (The Strengthening the Reporting of Observational Studies).</p>\",\"PeriodicalId\":50236,\"journal\":{\"name\":\"Journal of Clinical Nursing\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2024-12-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Clinical Nursing\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/jocn.17604\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Nursing","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/jocn.17604","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}
Multivariable Analysis of Factors Associated With Intravenous Access First Attempt and Overall Success in Hospitalised Medical-Surgical Adults.
Aims: To determine patient and nursing factors associated with peripheral intravenous access success among hospitalised adults on medical-surgical units.
Design: A prospective, cross-sectional, correlational design was guided by STROBE.
Methods: Within a quaternary care hospital with multiple medical-surgical units, nurses who attempted intravenous access completed case report forms and medical records were reviewed to record 38 factors associated with intravenous access success. After identifying factors associated with first attempt and overall intravenous access success in univariate analyses, prediction models were fit and calibration (based on plots) and discrimination (using the C-statistic) were evaluated using bootstrap sampling.
Results: Of 394 adults, 244 (61.9%) had first attempt and 323 (82.0%) had overall intravenous access success. Ultrasound was used in 227 (57.6%) intravenous access attempts and use was associated with less vein visibility and palpability and higher nurse perception of difficult intravenous access. In multivariable modelling, four factors were associated with first attempt intravenous access success: using a wrist vein, higher nurse expertise in intravenous access, nurse use of an ultrasound in patients with high-risk vein characteristics, and higher nurse confidence in first attempt success; model goodness of fit was good. Seven factors were associated with overall intravenous access success: shorter patient hospital length of stay, no history of diabetes, higher patient anxiety level, nurse use of an ultrasound in patients with high-risk vein characteristics, higher nurse expertise in intravenous access, higher nurse confidence in first attempt success, and nurse prediction of difficult intravenous access was low; model goodness of fit was strong.
Conclusion: Patients' vein characteristics and nurses' confidence in first attempt intravenous access success were predominant characteristics of intravenous access success.
Implications: Factors of importance in achieving intravenous access can be easily assessed prior to first attempt and may enhance first attempt and overall success.
Reporting method: Authors adhered to relevant EQUATOR guidelines and used the following reporting method: STROBE (The Strengthening the Reporting of Observational Studies).
期刊介绍：
The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice.
JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice.
We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.
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