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Needle Insertion Difficulty Algorithm (NIDA): A novel pilot study to predict Huber needle insertion difficulty in

Giuseppe Civetta1,2, Lucia Lombardi1, Antonio Lanotte1

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Successfully inserting Huber needles into totally implanted central venous access devices (TIVADs) depends on port type and clinician experience. The Needle Inserting Difficulty Algorithm (NIDA) predicts insertion success, improving patient care and reducing complications.

Keywords:
AlgorithmHuber needleassessmentindexport

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Area of Science:

  • Oncology
  • Vascular Access Devices
  • Medical Device Technology

Background:

  • Central venous access devices (TIVADs) are crucial for cancer patient treatment delivery.
  • Huber needle insertion into TIVAD ports can be challenging, impacting patient satisfaction and potentially causing extravasation injuries.
  • Variability in insertion success is linked to TIVAD type and clinician skill.

Purpose of the Study:

  • To develop a method for assessing TIVAD characteristics and clinician performance.
  • To create a prognostic index predicting the difficulty of Huber needle insertion into TIVADs.
  • To identify key factors influencing successful first-attempt Huber needle insertion.

Main Methods:

  • Development of the Subcutaneous Port Investigator Assessment (SPIA) method to categorize TIVADs.
  • Collection of data from medical records, including port type, insertion attempts, and clinician experience.
  • Creation of the Needle Inserting Difficulty Algorithm (NIDA) based on collected data.

Main Results:

  • TIVAD type (brachial vs. thoracic implant) significantly predicts insertion difficulty (p<0.001).
  • SPIA type (1, 2, or 3) and clinician experience are critical factors in successful insertion (p<0.001).
  • NIDA effectively serves as a prognostic index for Huber needle insertion success.

Conclusions:

  • Successful first-attempt Huber needle insertion is influenced by port type, SPIA classification, and clinician expertise.
  • The NIDA can help predict and potentially mitigate challenges associated with TIVAD access.
  • Optimizing these factors can improve patient outcomes and reduce the risk of extravasation injuries.