A Brief Intervention by Nurses to Reduce the Prescribing of Occluded Peripheral Venous Catheters in the Emergency Department
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: question for the prescriber.
- Who it may be relevant to
- Registry conditions: an Initial Order for a Blood Draw and Placement of an IV Line in the Emergency Department. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- France
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
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.
Interventions
- Other question for the prescriber
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?
Primary outcome measures
- the proportion of obturator catheters placed improperly [Time frame: day 1]
Secondary outcome measures (5)
- Correlation between the physician's final decision and nurse activity [Time frame: day 1]
- Use of the numerical pain scale during obturator catheter placement [Time frame: at the end of procedure (assessed up to 20 minutes)]
- Micro-costing analysis [Time frame: at the end of procedure (assessed up to 20 minutes)]
- Types of intravenous medications administered [Time frame: day 1]
- Number of orders for obturator catheters [Time frame: day 1]
Eligibility criteria
Inclusion criteria
- Patients assigned a triage score of 3A, 3B, or 4 according to the French triage scale, or 3 or 4 according to the CIMU triage scale, by the triage nurse
- Patients with a blood draw order involving the placement of an occluded catheter
- Age 18 years or older
- Patients who have read and understood the information sheet
- Patients who have given their verbal consent to participate in the study
- Patients enrolled in a social security program
Exclusion criteria
- Patients admitted to the emergency department with a pre-existing intravenous line
- Patients treated by the Mobile Emergency and Resuscitation Unit outside the hospital
- Patients with a blocked catheter who did not undergo an initial blood draw
- Patient with known neurocognitive disorders incompatible with informed consent
- Pregnant or breastfeeding woman
- Patient under legal guardianship (guardianship or conservatorship) or patient deprived of liberty
- Patient refusing to participate in the study
- Patient participating in another interventional research study
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- N/A
- Model
- Sequential
- Masking
- Open label
- Primary purpose
- Other
Study locations
France · 16 centers
- CHU Amiens — Amiens
- CHU Angers — Angers
- Chu Clermont Ferrand — Clermont-Ferrand
- APHP Henri Mondor — Créteil
- Ch Dieppe — Dieppe
- APHP CH Simone Veil — Eaubonne
- HCL Lyon Sud — Lyon
- HIA Laveran Marseille — Marseille
- … and 8 more centers
Identifiers
NCT: NCT07584590 · 2023/0302/HP