Association between peripheral venous catheter failure and care complexity factors in emergency department: a cross-sectional study.

Abstract

The objective was to determine the prevalence of peripheral venous catheter (PVC) failure and its association with care complexity individual factors (CCIFs) in emergency department (ED) patients. A cross-sectional, descriptive-correlational study was performed. All patients with a PVC inserted in the ED of a tertiary hospital were included. The period of study was from June 2021 to June 2022. The main outcomes were PVC failure (phlebitis, extravasation/infiltration, dysfunction/occlusion and dislodgement/involuntary withdrawal) and 26 CCIFs categorised into 5 domains (psycho-emotional, mental-cognitive, sociocultural, developmental and comorbidity/complications). Other secondary variables were also collected, such as level of triage or nursing care plan. All data were collected retrospectively from the electronic health records. A descriptive and inferential analysis was performed. A total of 35 968 patients with one or more PVC inserted during their ED visit were included in the study. The prevalence of PVC failure was 0.9% (n=316). The statistically significant CCIFs associated with PVC failure were: incontinence, haemodynamic instability, transmissible infection, vascular fragility, anxiety and fear, impaired adaptation, consciousness disorders, lack of caregiver support and agitation. In addition, we identified that patients with a higher number of CCIFs were more frequently experienced PVC failure. This study identified a prevalence of PVC failure in the ED of around 1%. The most prevalent complication was dysfunction, followed by extravasation and dislodgement. In addition, PVC failure was associated with comorbidity/complications, psycho-emotional and mental-cognitive CCIFs domains.