A Formalized Venous Assessment Process for Vascular Access Reduces Inequities Related to Race and Sex: A Propensity-Matched Analysis.

BACKGROUND

Individuals identifying as Black and/or female experience disparities in peripheral intravenous catheter (PIVC) outcomes. Improving preinsertion venous assessment may help mitigate these inequities.

PURPOSE: The purpose of this study was to evaluate the effect of a standardized venous assessment approach on PIVC functionality and equity.

METHODS

We performed a propensity-matched pre-post analysis of hospitalized adult emergency department patients before and after implementation of standardized venous assessment within a venous access training program (Operation STICK). The primary outcome was PIVC functionality.

RESULTS

A total of 1796 encounters were analyzed (898 per cohort). Mean age was 64.8 years; 59.4% were female and 40.7% were Black. Preintervention, traditionally placed PIVCs in White males demonstrated 19.5% longer functionality than those in Black females ( P = .03); this disparity was eliminated postintervention ( P = .85).

CONCLUSIONS

Standardized venous assessment with objective escalation to ultrasound improves PIVC outcomes and eliminates observed racial- and sex-based disparities.