Historically, the idea of success in vascular access was defined by issues such as number of attempts at insertion or infection rates. It is important that these measures continue. However, it is now time that we also look at additional measures of success. These may include:
- Phlebitis rates
- Occlusion rates
- Dislodgement rates
Overall, the question we should ask ourselves is ‘did the device reach your expected outcome’. In other words, did the device reach its intended dwell time. This approach ensures a preventative approach it adopted for vascular access that extends beyond traditional infection prevention. If we take phlebitis as an example; in an unpublished review phlebitis rates changed from 5.1% to 2.2%.
The details of the review compared 1078 peripheral IV removals in 2005 with 846 removals in 2011. The review concentrated on the incidence of phlebitis. When converted to percentages the phlebitis rate for 2005 was 5.1%; in 2011 the rate was 2.2%. Not only did the percentage of phlebitis rates vary, it was also found that the severity of phlebitis reduced in 2011. In 2005 Visual Infusion Phlebitis (VIP) scores ranged between two and three (one incidence of four). However, in 2011 the highest recorded phlebitis score was two using the Visual Infusion Phlebitis score.