New Research Published in the Journal of the Association for Vascular Access
Study Published in the Journal of the Association for Vascular Access Offers Evidence to Support the Use of B. Braun Medical’s Peripheral IV Checklist.
Bethlehem, New research published in a recent issue of the Journal of the Association for Vascular Access offers validity and reliability evidence supporting the use of B. Braun Medical Inc.’s Peripheral IV Catheter (PIVC) Insertion Skills Checklist© to measure best practice procedural performance of clinicians in a simulated environment.1
The PIVC insertion skills checklist was developed as a skills assessment tool for use during a six-month comprehensive PIVC simulation-based blended learning study involving medical/surgical nurses at Overlook Medical Center, part of Atlantic Health System, a leading healthcare delivery system in New Jersey.
Clinical performance variability has been associated with PIVC procedural failures, including multiple insertion attempts, patient discomfort, and frequent catheter failure.2 PIVC failure rates due to phlebitis, infiltration, dislodgement, mechanical failure, or infection range between 35% and 50% and lead to premature catheter removal.2 These adverse events increase patient discomfort, delay vital therapy, and increase healthcare costs through extended treatment and length of hospital stay.2 The global financial burden for premature PIVC removal has been conservatively estimated to range from $9.8 to $17.5 billion annually, considering the reported PIVC failure rates of 35%-50%, multiplied by the estimated 1 billion PIVCs inserted each year worldwide, and by the reported uncomplicated procedure cost range of $28-$35.1-3
“Accurately measuring the PIVC insertion skill of clinical staff is an integral, but missing, part of the PIVC procedure quality improvement process,” said Kevin Glover, Corporate VP, Clinical Education, Training, and Outcomes Research at B. Braun. “A tool with validity and reliability evidence is needed to uncover clinical variation, intervene with appropriate training, and monitor and report on the clinical quality and cost of care outcomes.”
“The PIVC checklist was designed to be used by trained Professional Advancement Clinical Tracks (PACT) nurse raters,” said Nowai Keleekai, PhD, RN, Nurse Researcher at Overlook Medical Center. “Overlook Medical Center raters attended B. Braun’s PIVC Checklist Observer Training Program©, a 3-hour classroom-based training program that included checklist instruction, deliberate practice with immediate feedback, and a summative debrief. To qualify as a rater, our PACT nurses were required to achieve a 90% or better minimum passing grade compared with a gold standard checklist for a minimum of 3 procedural observations.
“In addition, B. Braun developed an interactive online reinforcement program to maintain nurse rater proficiency between time gaps in checklist use and to help ensure consistency of results. Raters were required to watch and score a minimum of one PIVC insertion procedure video within 5 days of a scheduled observation session,” Keleekai said.
Catherine Schuster, PhD, RN, Nurse Researcher at B. Braun Medical, said: “The PIVC Insertion Skills Checklist was used multiple times by eight trained PACT nurse raters, to assess the PIVC insertion skills of 63 medical/surgical nurses working full time at Overlook Medical Center. The checklist performed with appropriately high internal consistency (α = 0.84), and combined with the rater training program was able to be used reliably by the eight nurse raters (ICC, 0.99; 95% CI, 0.99-0.99). To our knowledge, this is the first PIVC insertion skills checklist to be published that includes validity and reliability evidence.”
About B. Braun
B. Braun Medical Inc., a leader in infusion therapy and pain management, develops, manufactures, and markets innovative medical products and services to the healthcare industry. The company is committed to eliminating preventable treatment errors and enhancing patient, clinician and environmental safety. B. Braun Medical is headquartered in Bethlehem, Pa., and is part of the
B. Braun Group of Companies in the U.S., which includes B. Braun Interventional Systems, Aesculap® and CAPS®.
Globally, the B. Braun Group of Companies employs more than 58,000 employees in 64 countries. Guided by its Sharing Expertise® philosophy, B. Braun continuously exchanges knowledge with customers, partners and clinicians to address the critical issues of improving care and lowering costs. To learn more about B. Braun Medical, visit www.BBraunUSA.com.
About Atlantic Health System
Atlantic Health System, headquartered in Morristown, New Jersey, is a leading non-profit health care delivery system in New Jersey. Its network includes Morristown Medical Center in Morristown, NJ; Overlook Medical Center in Summit, NJ; Newton Medical Center in Newton, NJ; Chilton Medical Center in Pompton Plains, NJ; Hackettstown Medical Center in Hackettstown, NJ; and Goryeb Children’s Hospital in Morristown, NJ, as well as Atlantic Rehabilitation, and Atlantic Home Care and Hospice. It also includes its subsidiary, Atlantic Ambulance Corporation.
Atlantic Health System comprises 1,747 licensed beds, more than 14,000 employees and more than 4,000 physicians. Atlantic Health System has a medical school affiliation with the Sidney Kimmel Medical College at Thomas Jefferson University; is part of Atlantic Accountable Care Organization, one of the largest ACOs in the nation, and is a member of AllSpire Health Partners.
1. Schuster, C., Stahl, B., Murray, C., Keleekai, N.L., & Glover, K.R. (2016). Development and testing of a short peripheral IV catheter insertion skills checklist. Journal of the Association for Vascular Access. 21(4):196-204
2. Helm RE, Klausner JD, Klemperer JD, Flint LM, Huang E. Accepted but unacceptable: peripheral IV catheter failure. J Infus Nurs 2015;38:189-203.
3. Alexandrou E, Ray-Barruel G, Carr PJ et al. International prevalence of the use of peripheral intravenous catheters. J Hosp Med 2015;10:530-533.