Vascular access device utilization and first-attempt success rate of large-bore short peripheral catheter after anesthetic induction in perioperative general anesthesia patients.

BACKGROUND

The selection, placement and management of vascular access devices for surgical patients constitute a complex, multidisciplinary process. The first-attempt success rate of large-bore short peripheral catheter after anesthetic induction is a core nursing quality metric. This study investigated vascular access device utilization and the success rate in perioperative patients, providing a scientific basis for management and enhancing the quality and safety of patient care.

METHODS

A retrospective observational study was conducted to collect data on surgical patients in the operating room, including vascular access device characteristics (size, number, placement site, and method), the first-attempt success rate of large-bore short peripheral catheter, intraoperative utilization and potential factors influencing the success rate. Vascular access device related complications were identified via electronic medical records review.

RESULTS

Among 5374 patients, 75.0% (4031) of short peripheral catheters were ⩾18-gauge and brought from the ward, while 25.0% (1343) were ⩽18-gauge. The size and number of vascular access devices were sufficient to meet clinical needs. One complication was identified: postoperative extravasation. The first-attempt success rate of large-bore short peripheral catheter was 87.4%. Multivariate logistic regression analysis identified body mass index (18.5-23.9: OR = 0.102, 95% CI: 0.041-0.253; 24-27.9: OR = 0.080, 95% CI: 0.034-0.189), visible (OR = 179.547, 95% CI: 81.491-395.593), and palpable (OR = 146.922, 95% CI: 78.398-275.339) veins after tourniquet placement, and circulating nurse seniority (⩾10 years: OR = 2.252, 95% CI: 1.173-4.323) as independent factors associated with the success rate. The area under the receiver operating characteristic curve was 0.897, indicating good discriminative efficacy.

CONCLUSIONS

Current vascular access devices, predominantly short peripheral catheters, were sufficient to meet intraoperative needs. This is the first report identifying the factors associated with the first-attempt success rate of large-bore short peripheral catheter.