OBJECTIVES

: To analyze the outcome measures related to the Peripheral Venous Catheter (PVCs) management, in the clinical practice, and to define economic resources absorption, with regard to presence or absence of PVCs implant standard procedure (use of three disposable devices for washing, infusion and cleaning of PVCs).

METHODS

: An observational prospective study was conducted within five Medical and Surgical Departments, involving two Liguria Region Hospitals. Consecutive cases were enrolled and placed into two different scenarios: 1) use of three disposable devices (Scenario 1); 2) use of only two or one disposable device (Scenario 2). Clinical and economic data were collected in order to define efficacy, safety and efficiency indicators. The portion of patients for whom the PVC was removed, because of the end of therapy and the PVC-related adverse event occurrence were retrieved. An activity-based costing approach was also implemented to define the PVCs process costs.

RESULTS

: 380 patients were enrolled, 18% of whom were placed in Scenario 1. For 86.8% of patients in Scenario 1 (vs 39.40% in Scenario 2, p-value=0.000), the PVC removal was due to the end of the therapy, presenting the best performance, and guaranteeing a lower adverse events occurrence rate.

Scenario 1 is economically sustainable. Despite higher cost in the technology used, Scenario 1 is related to a lower overall process cost, given the occurrence of fewer adverse events (€19.60 vs €21.71, p-value>0.0019), thus also presenting an overall lower time of execution (on average 4.39 vs 5.72 minutes, p-value=0.000).

CONCLUSIONS

: Results demonstrated the importance to consider efficacy, safety and organizational measures, instead of only economic aspects. Scenario 1 reported a lower adverse events incidence, and fewer attempts in PVC cannulation, with a consequent costs minimization, resulting in the dominant technological solution and increasing the operational efficiency related to the procedure.