Factors affecting difficult peripheral intravenous cannulation in adults: a prospective observational study

Area of Science:

• Medical Imaging and Radiology
• Vascular Access Procedures
• Nursing Research

Background:

• Difficult peripheral intravenous catheterisation poses challenges in healthcare settings.
• Early identification of at-risk patients is crucial for successful cannulation and appropriate treatment strategies.

Purpose of the Study:

• To identify risk factors for difficult intravenous cannulation in adult patients in a radiology service.
• To analyze patient, healthcare provider, and device characteristics influencing cannulation success.

Main Methods:

• Prospective observational study involving 763 adult patients in an Italian university hospital's radiology service.
• Data collected by 13 nurses on patient characteristics, cannula details, and venepuncture procedures.
• Logistic regression analysis (univariate and multivariate) to determine predictors of difficult cannulation (defined as >1 minute).

Main Results:

• Significant predictors of difficult intravenous cannulation included chemotherapy via peripheral cannula (OR=1.42), veins with many valves (OR=3.67), and vein fragility (OR=3.29).
• Vein visibility (OR=0.87) and palpability (OR=0.79) were also identified as significant predictors.
• Intravenous insertion time varied widely, from 45 seconds to 125 minutes.

Conclusions:

• Despite identified risk factors, a high overall success rate suggests effective nursing interventions.
• Nurses' awareness of risk factors can help preserve peripheral veins and improve venepuncture outcomes.
• Further multicenter studies are recommended to validate findings across diverse settings.