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A Formalized Venous Assessment Process for Vascular Access Reduces Inequities Related to Race and Sex: A
Amit Bahl1, Yuying Xing, Arshaan Bastani
1Author Affiliations : Department of Emergency Medicine, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan (Dr Bahl and Mr Bastani); Corewell Health Research Institute, Royal Oak, Michigan (Dr Xing); and Department of Medicine, Creighton University School of Medicine, Omaha, Nebraska (Dr Mielke).
Background:
Individuals identifying as Black and/or female experience disparities in peripheral intravenous catheter (PIVC) outcomes. Improving preinsertion venous assessment may help mitigate these inequities.
Purpose:
The purpose of this study was to evaluate the effect of a standardized venous assessment approach on PIVC functionality and equity.
Methods:
We performed a propensity-matched pre-post analysis of hospitalized adult emergency department patients before and after implementation of standardized venous assessment within a venous access training program (Operation STICK). The primary outcome was PIVC functionality.
Results:
A total of 1796 encounters were analyzed (898 per cohort). Mean age was 64.8 years; 59.4% were female and 40.7% were Black. Preintervention, traditionally placed PIVCs in White males demonstrated 19.5% longer functionality than those in Black females ( P = .03); this disparity was eliminated postintervention ( P = .85).
Conclusions:
Standardized venous assessment with objective escalation to ultrasound improves PIVC outcomes and eliminates observed racial- and sex-based disparities.
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