Near-Infrared Informed Huddle for Neonatal Peripheral Intravenous Catheterization
Year: 2025
Type: article
Study design: Clinical Trial
Abstract: PURPOSE: Implement and evaluate near-infrared (NIR) huddles for neonatal peripheral intravenous catheter (PIVC) insertion. METHODS: An implementation project investigated PIVC insertion attempts, site, inserter designation, dwell, and complications during 3 phases (baseline, education, and implementation). Implementation consisted of planning insertion site(s) and attempt frequency with an NIR device huddle. The primary effectiveness outcome was first-time insertion success. Secondary outcomes included: PIVC completion/failure, failure reason, complications. Implementation outcomes were compliance, utility, and acceptability. The association between study phase and primary outcome was assessed using logistic regression. Exploratory analyses investigated intrinsic and extrinsic risks for PIVC insertion failure. RESULTS: Over 5 months, data from 248 (33%) neonates with 771 admissions was collected. Fifty-nine (24%) neonates required multiple PIVCs; resulting in 370 cannulations (n = 94 baseline, n = 55 education, and n = 221 intervention phases). Median birthweight was 2909 grams (IQR 2033-3499), gestation was 37.3 weeks (IQR 33.9-38.9). Length of stay, weight, gestation, and previous PIVC events were similar across phases. Insertion success was lower during education (n = 15, 39.5%) than baseline (n = 29, 56.9%), but differences were not significant. Acceptability of huddle process was higher (mean = 7.5/10, SD 2.2) than NIR device (mean = 5.0/10, SD 3.7). First time insertion failure was higher for forearm compared to hand/wrist (OR 5.94; 95% CI 1.22-28.87). CONCLUSION: The implementation of NIR-huddle failed to improve first-time insertion success, but PIVC dwell time and documentation were improved. Further research is needed to minimize harm and improve neonatal vascular access preservation.
Authors: Deanne August, Nicole Marsh, Stephanie Hall, Ruth Royle, Linda Cobbald, Pieter Koorts, Linda McLaughlin, Gillian Lack, Danika Iminof, Katie Foxcroft, Robert S. Ware, Amanda Ullman
Language: English
Subfield: Emergency Medical Services
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4407770284