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Updated: Aug 12, 2026
A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
Published on: July 13, 2019
Factors Associated With Non-First-Attempt Success in Peripheral Intravenous Cannulation by an Intravenous Therapy
Mei-Jung Wu1,2, Ming-Chin Lin3,4,5, Chi-Ming Yang2
1Research Center in Nursing Clinical Practice, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
Background:
Difficult peripheral intravenous cannulation affects a substantial proportion of hospitalized patients, yet factors associated with cannulation failure among cases assisted by a dedicated intravenous therapy team on general wards remain poorly characterized.
Aim:
To identify patient-related, operator-related, and procedural factors independently associated with non-first-attempt success in peripheral intravenous cannulation performed by an intravenous therapy team on general medical and surgical wards.
Design:
Prospective observational study and secondary analysis of prospectively collected clinical data.
Methods:
Cannulation events recorded by an intravenous therapy team over a 1-year period were analysed. The primary outcome was non-first-attempt success, defined as requiring two or more insertion attempts. A generalized linear mixed model accounted for repeated events within hospitalizations. Three sensitivity analyses assessed robustness.
Results:
Approximately one in five events required two or more attempts. Five factors were independently associated with non-first-attempt success: lower nurse experience, reduced patient mobility, smaller catheter gauge, replacement prompted by difficult access, and lower-limb or trunk insertion sites. Patient age, sex, comorbidity burden, and body mass index were not independently associated. Findings were robust across all sensitivity analyses.
Conclusion:
Nurse experience, catheter gauge, and insertion site are modifiable factors associated with first-attempt success. Patient mobility emerged as a novel, easily assessable risk indicator.
Implications For The Profession And/Or Patient Care:
Findings can inform intravenous therapy team training priorities, catheter gauge and insertion-site selection protocols, and prospective bedside risk screening to reduce repeated cannulation attempts.
Impact:
This study clarified which factors drive cannulation failure on general wards, identifying five independently associated factors-three of them modifiable-and highlighting patient mobility as a novel indicator relevant to intravenous therapy teams, ward nurses, and hospitalized adults internationally.
Reporting Method:
This study adhered to the STROBE reporting guideline for observational studies.
Patient Or Public Contribution:
No patient or public contribution.
