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Pediatric invasive device utility and harm: a multi-site point prevalence survey
Mari Takashima1,2, Victoria Gibson3,4, Eloise Borello5
1School of Nursing, Midwifery and Social Work, The University of Queensland, St Lucia, QLD, Australia. m.takashima@uq.edu.au.
Insights
Pediatric patients frequently use invasive devices, with nearly 80% requiring them. A significant number of these devices, particularly vascular access devices, experienced complications or failure, highlighting the need for improved safety strategies.
Area of Science:
- Pediatric Healthcare
- Medical Device Safety
- Hospital-Acquired Complications
Background:
- Invasive devices are essential in healthcare but pose risks, especially to vulnerable pediatric populations.
- This study addresses the critical need to understand invasive device use and associated harms in children.
Purpose of the Study:
- To investigate the prevalence, utility, and complications of invasive devices in Australian pediatric tertiary hospitals.
- To analyze clinical practices related to invasive device management and removal in pediatric patients.
Main Methods:
- A multi-center, observational, rolling-point-prevalence survey was conducted in 2022-2023.
- Inpatients were randomly sampled, and patients with devices were followed for up to 3 days.
- Data collected included device-related complications, failures, and management characteristics.
Main Results:
- 78.2% of 285 audited pediatric patients had at least one invasive device (412 total devices).
- Vascular access devices (54.1%) and gastrointestinal devices (27.2%) were most common.
- Point prevalence of device complications was 10.7% on Day 0, rising to 27.7% over the audit period, with a 13.4% device failure rate.
Conclusions:
- A high prevalence of invasive devices necessitates vigilant monitoring in pediatric settings.
- One-in-ten devices failed during the audit period, indicating potential for harm.
- Improved strategies are crucial to minimize complications and enhance the safety of invasive devices for children.
Background And Aims:
Invasive devices are widely used in healthcare settings; however, pediatric patients are especially vulnerable to invasive device-associated harm. This study aimed to explore invasive device utility, prevalence, harm, and clinical practice across three Australian pediatric tertiary hospitals.
Methods:
In 2022-2023, a multi-center, observational, rolling-point-prevalence survey was conducted. Fifty-per-cent of inpatients were systemically sampled by random allocation. Patients with devices were then followed for up to 3-days for device-related complications/failures and management/removal characteristics.
Results:
Of the 285 patients audited, 78.2% had an invasive device (n = 412 devices), with a median of 1 device-per-patient (interquartile range 1-2), with a maximum of 13 devices-per-patient. Over half of devices were vascular access devices (n = 223; 54.1%), followed by gastrointestinal devices (n = 112; 27.2%). The point-prevalence of all device complications on Day 0 was 10.7% (44/412 devices) and period-prevalence throughout the audit period was 27.7% (114/412 devices). The period-prevalence of device failure was 13.4% (55/412 devices).
Conclusions:
The study highlighted a high prevalence of invasive devices among hospitalized patients. One-in-ten devices failed during the audit period. These findings underscore the need for vigilant monitoring and improved strategies to minimize complications and enhance the safety of invasive devices in pediatric hospital settings.
Impact:
A high prevalence of invasive devices among hospitalized patients was reported. Of the 285 patients audited, almost 80% had an invasive device (total 412 devices), with a median of 1 device-per-patient and a maximum of 13 devices-per-patient. The most common devices used in pediatric healthcare are vascular access devices (n = 223; 54.1%), however, 16% (n = 36) of these devices failed, and one-third had complications. The point prevalence of all device complications at day 0 was 10.7% (44 out of 412 devices), with a period prevalence of 27.7% (114 out of 412 devices) throughout the audit period.
