First-attempt success rate of large-bore short peripheral catheter placement
Abstract:
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.
Reference:
Zhi LJ, Liu FR, Wang MS, Yang W. Vascular access device utilization and first-attempt success rate of large-bore short peripheral catheter after anesthetic induction in perioperative general anesthesia patients. J Vasc Access. 2026 Jul 30:11297298261468645. doi: 10.1177/11297298261468645. Epub ahead of print. PMID: 42533390.