Near-Infrared Informed Huddle for Neonatal Peripheral Intravenous Catheterization: A Pre-Post-Intervention Study

Area of Science:

• Neonatal care
• Medical device implementation
• Vascular access

Background:

• Neonatal peripheral intravenous catheter (PIVC) insertion is challenging, with high failure rates.
• Improving first-time insertion success and minimizing complications are critical for neonatal patient outcomes.
• Near-infrared (NIR) technology offers potential for guiding vascular access procedures.

Purpose of the Study:

• To implement and evaluate the effectiveness of near-infrared (NIR) huddles for neonatal PIVC insertion.
• To assess the impact of NIR huddles on first-time insertion success, dwell time, and complications.
• To determine the compliance, utility, and acceptability of the NIR device huddle implementation.

Main Methods:

• An implementation project evaluated PIVC insertion outcomes across three phases: baseline, education, and intervention with NIR huddles.
• Data collected included insertion attempts, site, inserter, dwell time, and complications.
• Logistic regression analyzed the association between study phase and first-time insertion success; exploratory analyses identified risks for PIVC failure.

Main Results:

• Over five months, 771 PIVC cannulations were analyzed in 248 neonates.
• First-time insertion success rates were 56.9% at baseline and 39.5% during the education phase, with no significant difference.
• Acceptability of the huddle process (mean 7.5/10) was higher than the NIR device itself (mean 5.0/10); forearm insertions had higher failure rates (OR 5.94).

Conclusions:

• The implementation of NIR huddles did not significantly improve first-time PIVC insertion success in neonates.
• The study indicated improvements in PIVC dwell time and documentation following NIR huddle implementation.
• Further research is recommended to optimize neonatal vascular access and minimize harm.