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RESEARCH ARTICLE
Contents Vol 48(5)

Hospital staff perspectives on the cost and efficiency of peripheral intravenous catheter use: a case study from three Australian hospitals

Kathleen McFadden A * , Claire M. Rickard B C D E , Christine Brown B C D , Amanda Corley B D E F , Jessica A. Schults B C D G , Alison Craswell https://orcid.org/0000-0001-8603-3134 D H I and Joshua Byrnes A
+ Author Affiliations
- Author Affiliations

A Centre for Applied Health Economics, School of Medicine and Dentistry, Menzies Health Institute Queensland, Griffith University, Brisbane, Qld, Australia.

B School of Nursing, Midwifery and Social Work, UQ Centre for Clinical Research, The University of Queensland, Brisbane, Qld, Australia.

C Herston Infectious Diseases Institute (HeIDI), Metro North Health, Brisbane, Qld, Australia.

D Schools of Nursing and Midwifery and Pharmacy and Medical Sciences, Alliance for Vascular Access Teaching and Research, Griffith University, Brisbane, Australia.

E Nursing Midwifery Research Centre, Royal Brisbane and Women’s Hospital, Brisbane, Qld, Australia.

F Adult Intensive Care Services and Critical Care Research Group, The Prince Charles Hospital, Brisbane, Qld, Australia.

G Child Health Research Centre, The University of Queensland, Brisbane, Qld, Australia.

H The University of the Sunshine Coast, Sunshine Coast Health Institute, Birtinya, Qld, Australia.

I Caboolture and Kilcoy Hospitals and Woodford Corrections, Caboolture, Qld, Australia.

* Correspondence to: k.mcfadden@griffith.edu.au

Australian Health Review 48(5) 519-523 https://doi.org/10.1071/AH24176
Submitted: 23 April 2024  Accepted: 29 July 2024  Published: 26 August 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.

Abstract

Peripheral intravenous catheters (PIVCs) are required by most hospitalised patients. Difficult intravenous access (DIVA) makes insertion challenging, with poor patient outcomes, treatment delays and resource waste from multiple insertion attempts, often by multiple clinicians. This exploratory qualitative case study aimed to investigate how clinical and executive hospital staff view PIVC insertions for patients with DIVA from a cost and efficiency perspective. Fifteen semi-structured interviews were conducted with staff from three large, urban Australian hospitals. Data was thematically analysed, with four themes generated: (1) PIVCs are not considered from a cost or resource use perspective; (2) resources required for successful PIVC insertion are variable and unpredictable; (3) limited funding and support exist for advanced skill and ultrasound-guided insertion; and (4) processes for PIVC training and competency are inefficient. Investment in advanced PIVC inserters (with ultrasound-guided cannulation skills, and ability to train and assess novice inserters), with clear escalation pathways to these clinicians may reduce inefficiencies and waste associated with difficult PIVC insertions.

Keywords: Australia, catheterisation, hospital costs, health economics, peripheral, qualitative, resource use, vascular access devices.

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