Peripheral venous access using devices over needles with and without extension: costs and outcomes

Lima, Antônio Fernandes Costa; Saba, Amanda; Neves Filho, Abílio Gonçalves das; Couto, Karen Aparecida; Silva, Luciana Oliveira e

doi:10.1590/0034-7167-2018-0921

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 73 (5) • 2020 • https://doi.org/10.1590/0034-7167-2018-0921 copy

Peripheral venous access using devices over needles with and without extension: costs and outcomes

Acceso venoso periférico utilizando dispositivos de aguja con y sin extensión: costos y resultados

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives:

to analyze the mean direct cost and peripheral venous access length outcomes using devices over needle with and without extension.

Methods:

quantitative, exploratory-descriptive research. Venous punctures and length of the devices were followed. The mean direct cost was calculated by multiplying the time (timed) spent by nursing professionals by the unit cost of labor, adding to the cost of materials.

Results:

the total mean direct cost of using devices “with extension” (US$ 9.37) was 2.9 times the cost of using devices “without extension” (US$ 4.50), US$ 7.71 and US$ 2.66, respectively. Totaling 96 hours of stay, the “device over needle with extension” showed a lower occurrence of accidental loss.

Conclusions:

the use of the “device over needle with extension”, despite its higher mean direct cost, was more effective in favoring adequate length of peripheral venous access.

Descriptors:
Vascular Access Devices; Medical-Surgical Nursing; Nursing Care; Costs and Cost Analysis; Cost Control

Variables	Device over needle		p value^† † p value - Chi-square test
	With extension	Without extension
	n= 64	n= 64
Diagnosis
Cardiac insufficiency	6	6	1.000
Hypertension	25	23	0.855
Systemic lupus erythematosus	4	6	0.744
Dyslipidemia	4	6	0.744
Diabetes Mellitus	17	20	0.697
Encephalopathy	4	2	0.680
Pneumonia	2	4	0.680
Chronic Kidney Disease	9	12	0.634
Stroke	1	3	0.619
Pleural effusion	2	0	0.496
Infection	8	4	0.364
Anemia	12	7	0.320
Chronic obstructive pulmonary disease	1	5	0.208
Cirrhosis	3	8	0.206
Acute Kidney Failure	4	0	0.119
Indication for PVA installation^* * PVA - peripheral venous access;
Painkiller administration	18	22	0.568
Electrolyte replacement	7	11	0.446
Hemotherapy administration	5	2	0.440
Antibiotic administration	22	27	0.467
Diuretic administration	12	7	0.223
Puncture attempt
01 attempt	54	43	0.038
02 attempt	10	19	0.143
03 attempt	0	2	0.496

Groups	Device over needle with extension				Device over needle without extension				p value^† † US$ - US$ conversion rate corresponding to US$ 0.31/R$, based on the quotation of July 29, 2016, provided by the Central Bank of Brazil; ‡ p value - Mann-Whitney test, p <0.005
Observations	Mean US$^† † US$ - US$ conversion rate corresponding to US$ 0.31/R$, based on the quotation of July 29, 2016, provided by the Central Bank of Brazil; ‡ p value - Mann-Whitney test, p <0.005	Standard Deviation US$^† † US$ - US$ conversion rate corresponding to US$ 0.31/R$, based on the quotation of July 29, 2016, provided by the Central Bank of Brazil; ‡ p value - Mann-Whitney test, p <0.005	Minimum US$^† † US$ - US$ conversion rate corresponding to US$ 0.31/R$, based on the quotation of July 29, 2016, provided by the Central Bank of Brazil; ‡ p value - Mann-Whitney test, p <0.005	Maximum US$^† † US$ - US$ conversion rate corresponding to US$ 0.31/R$, based on the quotation of July 29, 2016, provided by the Central Bank of Brazil; ‡ p value - Mann-Whitney test, p <0.005	Mean US$^† † US$ - US$ conversion rate corresponding to US$ 0.31/R$, based on the quotation of July 29, 2016, provided by the Central Bank of Brazil; ‡ p value - Mann-Whitney test, p <0.005	Standard Deviation US$^† † US$ - US$ conversion rate corresponding to US$ 0.31/R$, based on the quotation of July 29, 2016, provided by the Central Bank of Brazil; ‡ p value - Mann-Whitney test, p <0.005	Minimum US$^† † US$ - US$ conversion rate corresponding to US$ 0.31/R$, based on the quotation of July 29, 2016, provided by the Central Bank of Brazil; ‡ p value - Mann-Whitney test, p <0.005	Maximum US$^† † US$ - US$ conversion rate corresponding to US$ 0.31/R$, based on the quotation of July 29, 2016, provided by the Central Bank of Brazil; ‡ p value - Mann-Whitney test, p <0.005
Cost of direct labor of nursing professionals (US$ ^† † US$ - US$ conversion rate corresponding to US$ 0.31/R$, based on the quotation of July 29, 2016, provided by the Central Bank of Brazil; ‡ p value - Mann-Whitney test, p <0.005 )	1.66	0.82	0.71	5.32	1.84	0.92	0.92	5.23	0.31
Material cost (US$ ^† † US$ - US$ conversion rate corresponding to US$ 0.31/R$, based on the quotation of July 29, 2016, provided by the Central Bank of Brazil; ‡ p value - Mann-Whitney test, p <0.005 )	7.71	2.28	6.67	13.80	2.66	0.74	1.71	4.29	<0.001
Total mean direct cost (US$ ^† † US$ - US$ conversion rate corresponding to US$ 0.31/R$, based on the quotation of July 29, 2016, provided by the Central Bank of Brazil; ‡ p value - Mann-Whitney test, p <0.005 )	9.37	2.79	7.38	19.12	4.50	1.29	2.74	8.99	<0.001

Clinical outcomes	Device over needles		p value^†
Clinical outcomes	With extension	Without extension	p value^†
First day	n=64	n=64
Absence of phlogistic signs	63	56	0.03
Pain	0	4	0.11
Accidental loss	1	4	0.36
Second day	n=63	n=56
Absence of phlogistic signs	50	51	0.82
Pain	5	0	0.05
Extravasation	1	1	1.00
Phlebitis	0	1	1.00
Accidental loss	1	2	1.00
End of therapy	6	1	0.20
Third day	n=50	n=51
Absence of phlogistic signs	45	41	0.57
Phlebitis	0	2	0.49
Accidental loss	0	4	0.11
End of therapy	5	4	0.71
Fourth day	n=45	n=41
Absence of phlogistic signs	43	36	0.27
Pain	1	1	1.00
Accidental loss	1	3	0.61
End of therapy	0	1	1.00
Everyday (96 hours)	n=64	n=64
Absence of phlogistic signs	43	36	0.27
Pain	6	5	1.00
Extravasation	1	1	1.00
Phlebitis	0	3	0.24
Accidental loss	3	13	0.01
End of therapy	11	6	0.27

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[1] Corresponding author: Antônio Fernandes Costa Lima. E-mail: tonifer@usp.br