Improving peripheral intravenous catheter insertion success in out-of-hospital settings

Peripheral intravenous catheter (PIVC) insertion is a critical component of patient care in out-of-hospital settings, with its use becoming routine for a wide array of therapies. However, repeated failed attempts at catheter insertion are both a source of patient distress and a contributing factor to suboptimal clinical and economic outcomes. This study examined the challenges associated with PIVC placement in out-of-hospital settings, specifically within the Lloyds Clinical service, where a diverse group of patients receives intravenous therapies, including oncology medications, antibiotics, and treatments for rare disorders. The study retrospectively analysed 16 241 nursing visits, identifying cases of failed initial PIVC insertion and exploring the causes behind these instances. Findings suggest that patient-related anatomical and physiological factors, such as vein visibility and previous medical interventions, account for the majority of failed insertions. A review of current literature highlighted the importance of addressing variability in nursing practices, enhancing educational frameworks, and adopting evidence-based guidelines to optimise PIVC insertion and management. Strategies such as patient education, localised warming techniques, and targeted nurse retraining were identified as potential ways to improve outcomes. The implementation of these strategies aims to enhance the overall patient experience and ensure optimal venous access success rates in out-of-hospital settings.