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Peripheral venous catheters are frequently inserted in hospitals, with approximately 25 million placed annually in France (HAS data, 2005). The occluded peripheral venous catheter with extension tubing has become the standard in some emergency departments, offering advantages such as patient mobility, the ability to perform repeated blood draws, and the administration of intravenous medications. A 2018 meta-analysis revealed that one in three devices was unnecessary. The placement of a occluded peripheral venous is associated with a more painful insertion, higher cost, and an increased risk of infection and thromboembolism, and blood samples obtained via the occluded peripheral venous catheter are more often hemolyzed than those obtained by direct venipuncture.
Communication between physicians and nurses is essential to ensure optimal patient care. A brief intervention by the nurse when a physician prescribes a occluded peripheral venous catheter can help clarify the appropriateness of this prescription, which could lead to reduced pain for the patient, time savings for healthcare providers, and material cost savings for the hospital.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Questions for the prescriber | Experimental | Once the nurse has received the doctor's order for a blood draw with a KTO, she will ask the prescribing physician: Is the KTO being prescribed for: the administration of medication? The injection of a contrast agent? A second blood draw? For each question, there are three possible answers: Yes? No? Maybe? |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| question for the prescriber | Other | Once the nurse has received the doctor's order for a blood draw with a KTO, she will ask the prescribing physician: Is the KTO being prescribed for: the administration of medication? The injection of a contrast agent? A second blood draw? For each question, there are three possible answers: Yes? No? Maybe? |
| Measure | Description | Time Frame |
|---|---|---|
| the proportion of obturator catheters placed improperly | Questions for the prescriber | day 1 |
| Measure | Description | Time Frame |
|---|---|---|
| Correlation between the physician's final decision and nurse activity | Correlation between the physician's final decision and the performance of a repeat biopsy, the administration of contrast dye, or the administration of intravenous treatment | day 1 |
| Use of the numerical pain scale during obturator catheter placement |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jessica BORTZMEYER, nurse | Contact | 02.32.88.89.90 | +33 | jessica.bortzmeyer@chu-rouen.fr |
| ROUSSEL Mélanie, MD | Contact | melanie.roussel@chu-rouen.fr |
| Name | Affiliation | Role |
|---|---|---|
| Déborah LEBEDIEFF, MS | University Hospital, Rouen | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU Amiens | Amiens | 80 000 | France |
|
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|
pain during obturator catheter placement |
| at the end of procedure (assessed up to 20 minutes) |
| Micro-costing analysis | Micro-costing analysis of the cost of a standard venous blood draw and a closed-catheter procedure | at the end of procedure (assessed up to 20 minutes) |
| Types of intravenous medications administered | Types of intravenous medications administered and available oral alternatives | day 1 |
| Number of orders for obturator catheters | Number of orders for obturator catheters placement during the initial blood draw for each period throughout the entire enrollment period | day 1 |
| CHU Angers | Angers | 49 100 | France |
|
| Chu Clermont Ferrand | Clermont-Ferrand | 63 000 | France |
|
| APHP Henri Mondor | Créteil | 94 010 | France |
|
| Ch Dieppe | Dieppe | 76 202 | France |
|
| APHP CH Simone Veil | Eaubonne | 95 600 | France |
|
| HCL Lyon Sud | Lyon | 69 495 | France |
|
| HIA Laveran Marseille | Marseille | 13013 | France |
|
| CHRU Nancy | Nancy | 54 000 | France |
|
| CHU Nantes | Nantes | 44 093 | France |
|
| APHP Lariboisière | Paris | 75 010 | France |
|
| AP HP Pitié Salpétrière | Paris | 75 013 | France |
|
| APHP Bichat | Paris | 75 018 | France |
|
| APHP St Antoine | Paris | 76 012 | France |
|
| CHU de ROUEN | Rouen | 76 031 | France |
|
| Chu Toulouse | Toulouse | 31 300 | France |
|