The impact of multiple insertions on peripheral intravenous access in low-birth-weight infants in perinatology
Abstract
Low-Birth-Weight (LBW) infants have very small veins, and there is a risk of needing multiple insertions to establish peripheral intravenous access. This study aimed to examine the impacts of multiple insertions during peripheral intravenous access in LBW infants. This cross-sectional study involved 216 respondents. Data were analyzed with the Spearman correlation. The results showed a significant relationship (p<α) between multiple insertions to establish peripheral intravenous access to LBW infants with increased pain, heart rate, respiratory rate, duration of crying, delayed treatment, duration of insertion, and high cost of care (p<0.001; r=0.358-0.836). Meanwhile, multiple insertions might decrease oxygen saturation and body temperature (p<0.001; r=0.358). In this study, multiple insertions were correlated with several negative impacts on the physiological function and discomfort of LBW infants. The study also highlights the effect on time of treatment precision and cost effectiveness. Recommendation: It is necessary to develop preventive measures to reduce the impact of multiple insertions to establish peripheral intravenous access in LBW infants.
References
- Lahat A, van Lieshout RJ, Mathewson KJ, et al. Extremely low birth weight babies grown up: Gene-environment interaction predicts internalizing problems in the third and fourth decades of life. Dev Psychopathol 2017;29:837-43. DOI: https://doi.org/10.1017/S0954579416000511
- Carbajal R, Courtois E, Droutman S, et al. O-101 number of procedures and analgesic therapy in neonates admitted to nicus: epippain 2 study. Arch Dis Child 2014;99:A62-3. DOI: https://doi.org/10.1136/archdischild-2014-307384.168
- Kassab M, Alhassan AA, Alzoubi KH, Khader YS. Number and frequency of routinely applied painful procedures in university neonatal intensive care unit. Clin Nurs Res 2019;28:488-501. DOI: https://doi.org/10.1177/1054773817744324
- Paparella SF, Mandrack MM. IV push medication administration: making safe choices; choosing best practice. J Emerg Nurs 2016;42:64-7. DOI: https://doi.org/10.1016/j.jen.2015.09.016
- Carr PJ, Rippey JCR, Cooke ML, et al. Derivation of a clinical decision-making aid to improve the insertion of clinically indicated peripheral intravenous catheters and promote vessel health preservation. An observational study. PLoS One 2019;14:e0213923. DOI: https://doi.org/10.1371/journal.pone.0213923
- Sharma PK, Singh SK. Venous access in neonates: our experience. Int J Contemp Pediatrics 2018;5:1571-5. DOI: https://doi.org/10.18203/2349-3291.ijcp20182567
- Legemaat M, Carr PJ, van Rens RM, et al. Peripheral intravenous cannulation: complication rates in the neonatal population: a multicenter observational study. J Vasc Access 2016;17:360-5. DOI: https://doi.org/10.5301/jva.5000558
- Cooke M, Ullman AJ, Ray-Barruel G, et al. Not "just" an intravenous line: consumer perspectives on peripheral intravenous cannulation (PIVC). An international cross-sectional survey of 25 countries. PLoS One 2018;13:e0193436. DOI: https://doi.org/10.1371/journal.pone.0193436
- Tandale SR, Dave N, Garasia M, et al. A study of morbidity and cost of peripheral venous cannulation in neonates admitted to paediatric surgical intensive care unit. J Clin Diagn Res 2017;11:UC08-10. DOI: https://doi.org/10.7860/JCDR/2017/23600.9570
- Vitaliti SM, Costantino G, Li Puma L, et al. Painful procedures in the NICU. J Matern Fetal Neonatal Med 2012;25:146-7. DOI: https://doi.org/10.3109/14767058.2012.714986
- Fields JM, Piela NE, Ku BS. Association between multiple IV attempts and perceived pain levels in the emergency department. J Vasc Access 2014;15:514-8. DOI: https://doi.org/10.5301/jva.5000282
- Witting MD. IV Access difficulty: incidence and delays in an urban emergency department. J Emerg Med 2011;42:483-7. DOI: https://doi.org/10.1016/j.jemermed.2011.07.030
- Brannam L, Blaivas M, Lyon M, Flake M. Emergency nurses' utilization of ultrasound guidance for placement of peripheral intravenous lines in difficult-access patients. Acad Emerg Med 2004;11:1361-3. DOI: https://doi.org/10.1111/j.1553-2712.2004.tb01929.x
- Goff DA, Larsen P, Brinkley J, et al. Resource utilization and cost of inserting peripheral intravenous catheters in hospitalized children. Hosp Pediatr 2013;3:185-91. DOI: https://doi.org/10.1542/hpeds.2012-0089
- Fitri SYR, Lusmilasari L, Juffrie M, Rakhmawati W. Pain in Neonates: a concept analysis. Anesth Pain Med 2019;9:e92455. DOI: https://doi.org/10.5812/aapm.92455
- Kenner C, Altimier LB, Boykova MV. Comprehensive neonatal nursing care. 6th ed. New York: Springer Publishing Company; 2019. DOI: https://doi.org/10.1891/9780826139146
- Johnston C, Campbell-Yeo M, Disher T, et al. Skin-to-skin care for procedural pain in neonates. Cochrane Database Syst Rev 2017;2:CD008435. DOI: https://doi.org/10.1002/14651858.CD008435.pub3
- Taufiq S. Prevalence and causes of wrong time medication administration errors, experience at a tertiary care hospital in Pakistan. Canadian J Nurs Inform 2015;10.
- Cameron EC, Raingangar V, Khoori N. Effects of handling procedures on pain responses of very low birth weight infants. Pediatr Phys Ther 2007;19:40-7. DOI: https://doi.org/10.1097/PEP.0b013e3180307c4f
- Saeidi R, Asnaashari Z, Amirnejad M, et al. Use of “kangaroo care” to alleviate the intensity of vaccination pain in newborns. Iran J Pediatr 2011;21:99-102.
- Donia AES, Tolba OA. Effect of early procedural pain experience on subsequent pain responses among premature infants. Egyptian Pediatric Association Gazette 2016;64:74-80. DOI: https://doi.org/10.1016/j.epag.2016.03.002
- Okan F, Ozdil A, Bulbul A, et al. Analgesic effects of skin-to-skin contact and breastfeeding in procedural pain in healthy term neonates. Ann Trop Paediatr 2010;30:119-28. DOI: https://doi.org/10.1179/146532810X12703902516121
- Padhye NS, Williams AL, Khattak AZ, Lasky RE. Heart rate variability in response to pain stimulus in VLBW infants followed longitudinally during NICU stay. Dev Psychobiol 2009;51;638-49. DOI: https://doi.org/10.1002/dev.20399
- Jafari H, Courtois I, Van den Bergh O, et al. Pain and respiration: a systematic review. Pain 2017;158:995-1006. DOI: https://doi.org/10.1097/j.pain.0000000000000865
- Handhayanti L, Rustina Y, Budiati T. Differences in temperature changes in premature infants during invasive procedures in incubators and radiant warmers. Compr Child Adolesc Nurs 2017;40:102-6. DOI: https://doi.org/10.1080/24694193.2017.1386977
- Hadaway L, Dalton L, Mercanti-Erieg L. Infusion teams in acute care hospitals: call for a business approach an infusion nurses society white paper. J Infus Nurs 2013;36:356-60. DOI: https://doi.org/10.1097/NAN.0b013e3182a123a9
- van Loon FH, Leggett T, Bouwman AR, Dierick-van Daele AT. Cost-utilization of peripheral intravenous cannulation in hospitalized adults: an observational study. J Vasc Access 2020;21:687-93. DOI: https://doi.org/10.1177/1129729820901653
- Walsh G. Difficult peripheral venous access: recognizing and managing the patient at risk. Journal of the Association for Vascular Access 2008;13:198-203. DOI: https://doi.org/10.2309/java.13-4-7
- Kuensting LL, DeBoer S, Holleran R, et al. Difficult venous access in children: taking control. J Emerg Nurs 2009;35:419-24. DOI: https://doi.org/10.1016/j.jen.2009.01.014
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