Factors Associated With Non‐First‐Attempt Success in Peripheral Intravenous Cannulation by an Intravenous Therapy Team: A Prospective Observational Study
Mei‐Jung Wu, Ming‐Chin Lin, Chi‐Ming Yang, Yi‐Chun Lin, Made Satya Nugraha Gautama, Tsai‐Wei HuangABSTRACT
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.