EFFECTS OF PERİPHERİC CATHATER INSERTİON SUPPORTED BY ACCUVEİN VASCULAR IMAGİNG DEVİCES

IN PEDİATRİC PATİENTS TO THE SUCCESS OF THE PROCESS

Duygu Demir1

Sevil İnal2

1Nurse, Pediatric Hematology and Oncology Service,Okmeydanı Educational and Research Hospital, İstanbul

2Istanbul University, Health Science Faculty, Midwifery Departmentduygu3186@hotmail.com

INTRODUCTION

Intravenous cathater application is the most encountered medical procedure for hospitalized

pediatric patients

Mostly, IV cathater application is made in order to achieve the cure succesfully and early recovery of the

patients

Vessel diameter is

small

Difficult to Place The IV Catheter in

Children Than Adults

Difficult to palpate

PainfulHard to tolerate

Thick subcutaneous

tissue

Moving Difficult to stabilize

• Nurse IV catheter should be aimed at atraumatic care• For this reason, it is important to use technologies that

reduces the pain and also shorten the process time by the nurse.

İn the long-termIV catheter applications

Repeated IV applications

Difficult IV Catheter Applications

The purpose of the nurse;• with minimal pain• As soon as• the minimum number of intravenous venture

with processes must perform

• IV catheter placement in pediatric patients in the limited research demonstrating the efficacy of different vascular imaging device

• There is no research Accuvein AV 400 demonstrating the effectiveness of the device

Literature review;

OBJECTİVES

İt is aimed to determine effects of peripherical

intravenous cathater insertion supported by Accuvein

vascular imaging device for pediatric patients

THE SUCCESS OF THE PROCESS

Practice Number Per Patient

Cathater İnsertion Period

Pain Threshold Of The Children

Materyal-Metod

• Randomized, controlled experimental study

• Sample, 3-18 years old 129 pediatric patients

• Interview and Observation Form

• Wong-Baker FACES Pain Scale (WBFPS-R)

• AccuVein AV 400 vascular ımagıng devıces

Vein Viewing System(AccuVein AV 400)

The patient has not affected by movement

Under the skin can scan up to 8 mm

Real-time scanning and showing

Weighing only (280g)

Cordless and rechargeable

It is non-contact and portable

Ability to work in light and dark

(accuvein.com)

Use Manually or With Hanger

Two Color Options

White Black

HİPOTEZLER

H0. Peripheral intravenous catheter implementation supported by Accuvein vascular imaging devices in pediatric patients has no effect on the success of the procedure in children.H1. Peripheral intravenous catheter implementation supported by Accuvein vascular imaging devices in pediatric patients reduces the pain during the procedure in children. H2. Peripheral intravenous catheter implementation supported by Accuvein vascular imaging devices in pediatric patients reduces the processing time in children.H3. Peripheral intravenous catheter implementation supported by Accuvein vascular imaging devices in pediatric patients increases the success of the procedure in children.

INCLUSİON CRİTERİA

Case and control subjects have been selected children will create the random methodDue to the treatment procedure IV catheter placement needs to beBoth the experimental and control groups at the same hospital where the children research service in designated inpatient treatment to be seen (Pediatric Hematology (n=54), Pediatric İnternal Medicine(n=75) ) Subject must be within 3-18 ages Same nurse practicing intravenous catheter implementation Same needle size for every intravenous catheter implementation (24-G) Not having taken an analgesic within the last 6 hours The stable health status Not having a developmental disorder that may result in not being

able to answer the pain and anxiety scales (mental retardation or hearing impairment)

Experimental Group

AccuVein assisted

Control Group

Conventional (standard) application method

İntervention

• Data were analyzed with SPSS 15.00.• The quantitative data; Student t Test, Mann

Whitney U testi • The qualitative data Pearson chi-square tests ve

Yates Continuity Correction test • Significance is obtained in p<0,01 and p<0,05

level.

Statistical Analysis

RESULTS

Experimental Group(n=72)

Control Group (n=57)

Mean±SD (Med). Mean±SD (Med).

Age (year) 8,51±4,41 (7,0) 9,34±4,54 (9,5) Z:-0,969 b0,333

BMI (kg/m2) 17,27±3,08 (16,6) 17,34±2,53 (17,1) t: -0,140 a0,889

Number of vascular

access establishment before the process

3,14±1,73 (3) 2,76±1,92 (3) Z: -1,355 0,175

Table1. Comparing The Experimental And The Control Group Success İn Terms Of Process Variables That Can

Affect-1

aStudent t Test bMann Whitney U Test

n %n %

χ2 p

SexFemale 32 44,4 27 47,4 0,110 c0,741

Male 40 55,6 30 52,6

Skin tone

White 39 54,2 34 59,6 0,567 c0,753

Brown 7 9,7 6 10,5

Dark 26 36,1 17 29,8

The degree of difficulty of the veins

Easy 24 33,3 26 45,6 2,355 c0,308

Medium 20 27,8 15 26,3

Difficult 28 38,9 16 28,1

Inserting the cannula in last 1 week

Yes 33 64,7 33 71,7 0,274 d0,600

No 18 35,3 13 28,3

Table 1. Comparing The Experimental And The Control Group Success İn Terms Of Process Variables That Can Affect -2

Tablo 2. IV Catheter Opening Process in Terms of The Time and Number of Attempts

Experimental Group(n=72)

Control Group (n=57)

Z pMean±SD

(Min-Max)Mean±SD

(Min-Max)

IV catheter opening process in terms of the time (sec)

37,24±20,07 (15-83)172,65±153,21

(40-700)-8,648 b0,001

Number of attempts

1,08±0,28 (1-2) 2,23±1,57 (1-8) -5,859 b0,001

aStudent t Test bMann Whitney U Test

The number of attempts in the experimental group than the control group advanced significantly lower (p <0.01).

The experimental group, a statistically high level of processing time significantly shorter in duration than

were observed (p = 0.001).

Pain Levels

Experimental Group(n=72)

Control Group (n=57)

Z p

Mean±SD(Min-Max)

Mean±SD(Min- Max)

Children’s assesment 2,61±1,37 (0-7) 6,40±2,38 (1-10) -7,915 b0,001

Observer’s assesment 2,14±0,97 (0-5) 5,30±2,52 (1-10) -7,575 b0,001

Children in the experimental group andthe expression of children's pain levels were assessed

according to the reports of both observersand statistically determined to be at an advanced level

was significantlylower (p = 0.001).

Tablo 3. Children’s Pain Levels

bMann Whitney U Test

0102030405060708090

100

Ora

n (%

)

%90.3

%9.7

%45.6%54.4

Accuvein Group Control Group

The success of the process (+) The success of the process (-)

Tablo 4. When Compared İn Terms Of The Success İn The First Attempt

Χ2 =28,429 dYates’ Continuity Correction Test

CONCLUSİON

Peripheral intravenous catheter implementation supported by Accuvein AV-400 vascular imaging

devices in pediatric patientsincreases the success of the procedure,

reduces the processing time andthe pain during the procedure

in children

Available in the Pediatrics Unit IV Catheter Placement

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