Intravenous Catheter Insertion Improvement

One of the nurses’ common responsibilities in the workplace is performing venipuncture for intravenous injection which allows liquid substances to be distributed evenly and have the desired effect on a patient. There is evidence that a significant number of nurses lack appropriate training which complicates catheter insertion. One of the suggested evidence-based practices in this case would be improving nurses’ knowledge of safe insertion. This essay will discuss the benefits of the said practice for patients, medical facilities, and on a larger scale.

When not done correctly, intravenous catheter insertion can result in many complications for a patient, for instance, fluids can leak into surrounding tissues and cause infiltrations. Extravasation can lead to even more severe outcomes including tissue damage, necrosis, and disfigurement (Marsh, Webster, Larson, Cooke, Mihala, & Rickard, 2018). Moreover, improper insertion may put a financial burden on a patient and his or her insurance provider: in the United States, each insertion costs approximately $28-35, given that there are no complications (Keleekai et al., 2016).

At the same time, nurses’ skills leave a lot of space for improvement. For instance, statistics show that among staff nurses, first insertion success rate ranges from 44% to 76.9% (Keleekai et al., 2016). On the contrary, more experienced and educated nurses can insert correctly at the first attempt in 98% of all cases (Keleekai et al., 2016). Thus, implementing the evidence-based practice of enhanced catheter insertion techniques will target three issues at one: patient dissatisfaction and adverse outcomes, financial burden, and variations in the delivery of care.

If this evidence-based practice is introduced nationwide, the ramification of the change will also positively affect health providers and empower them to continue learning and practicing. Intravenous catheter insertion can be a challenging task for newbies especially when they cannot receive guidance in the workplace. If nurses have access to training and are familiar with the standards, they are more likely to experience role satisfaction. Admittedly, empowerment and fulfillment in the workplace on par with fewer patient complaints and complications will account for a decrease in healthcare provider turnover rate.

The plan on improving nurses’ knowledge about intravenous catheter insertion should also include spreading information about peripherally inserted central catheters (PICC). Some studies have shown that the use of this type of catheters has grown significantly in recent years (Woller, Stevens, & Evans, 2016). However, the use of PICC has been associated with severe complications in patients such as thrombosis and infection (Woller et al., 2016).

When patients give consent to intravenous insertion, they do not expect to face any of the mentioned complications, and their insurance plan may not be covering them. Thus, if medical facilities provide training for staff and switch to safer catheters, there will be a decline in payment and reimbursement denials from third party payers – insurance companies. Lastly, with the availability of medical information on the Internet, many patients may be aware of safe, evidence-based practices, and their implementation will meet their expectations about care quality.

Intravenous catheter insertion is a routine procedure at many hospitals. Despite its perceived simplicity, many nurses lack appropriate training which negatively affects the success rate of the first insertion. Improper insertion and premature removal may lead to numerous complications in a patient resulting in a financial burden and unnecessary suffering. At the same time, nurses who fail to conduct a procedure due to insufficient knowledge may feel discouraged and dissatisfied with their role.

Lastly, a medical facility may be confronted with payment and reimbursement denials in case handling complications is not covered by a patient’s insurance. Introducing enhanced techniques of intravenous catheter insertion and avoiding the use of peripherally inserted central catheters will tackle the mentioned issues and increase the quality of care at a medical facility.

References

Keleekai, N. L., Schuster, C. A., Murray, C. L., King, M. A., Stahl, B. R., Labrozzi, L. J., … Glover, K. R. (2016). Improving nurses’ peripheral intravenous catheter insertion knowledge, confidence, and skills using a simulation-based blended learning program: A randomized trial. Simulation in Healthcare: Journal of the Society for Simulation in Healthcare, 11(6), 376-384.

Marsh, N., Webster, J., Larson, E., Cooke, M., Mihala, G., & Rickard, C. M. (2018). Observational study of peripheral intravenous catheter outcomes in adult hospitalized patients: A multivariable analysis of peripheral intravenous catheter failure. Journal of Hospital Medicine, 13(2), 83-89.

Woller, S. C., Stevens, S. M., & Evans, R. S. (2016). The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) initiative: A summary and review of peripherally inserted central catheter and venous catheter appropriate use. Journal of Hospital Medicine, 11(4), 306-310.

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