FIRST ATTEMPT PERIPHERAL INTRAVENOUS CANNULATION FAILURE AND ASSOCIATED FACTORS AMONG CHILDREN ADMITTED TO PUBLIC HOSPITALS OF WEST ARSI, OROMIA,

Abstract

Background: Peripheral intravenous cannulation failure refers to the failure of establishing a sound venous access. Despite several evidence-based improvement strategies have been proposed, up to 50% of first-attempt insertions in children fail, leading to delays in medical treatment and an increased work load for health care providers. However, despite the problem exists, there is limited data in developing nations including Ethiopia. Therefore, recognizing the prevalence and the factors associated with first attempt insertion failure would help for establishing targets for clinically important enhancements in child safety. Objective: The aim of this study was to assess the prevalence of first attempt peripheral intravenous cannulation failure and associated factors among children admitted in public hospitals of West Arsi Zone, Oromia, Ethiopia. Methods: An institution-based cross-sectional study was conducted among 576 admitted children from July 23 until September 23, 2024. A systematic random sampling technique was used to select the study participants. A structured interviewer-administered questionnaire and observation checklist were used to collect data. The data were checked for completeness, entered into Epi-Data version 4.7, and exported to SPSS version 25.0 for analysis. Bivariable and multivariable logistic regression analysis with a 95% CI, crude odds ratio, and adjusted odds ratio were used to identify factors associated with the outcome variable, and statistical significance was declared at a P-value < 0.05. Then the results were presented with text, tables, graphs, and figures for different variables. Result: A total of 548 children’s were involved with a response rate of 95% and 39.1% of children have had a failed first cannulation attempt. Factors like vein visibility with a tourniquet (AOR= 0.21, 95%CI: 0.07–0.58), clinical history of difficult peripheral intravenous cannulation (AOR= 3.56, 95%CI: 1.37–9.27), presence of chronic disease (AOR=2.79, 95%CI: 1.04 –7.44), child age <2 years (AOR = 4.04, 95%CI: 1.30–12.55), and 2–5 years (AOR = 3.35, 95%CI: 1.12–10.02) were significantly associated with a failed first attempt of intravenous cannulation. Similarly, insertion sites on cubital-fossa (AOR = 4.81, 95% CI: 1.08–18.31) and wrist (AOR=4.09, 95%CI: 1.17–14.28) were also statistically significant factors for first attempt peripheral intravenous cannulation failure. Conclusion: This study shows that in two-fifth of the patients, intravenous cannulation required more than one attempt, which is higher than that of results identified in analogous studies and it was associated with vein visibility, previous history of difficult peripheral intravenous canulation, chronic disease, age, and insertion site. Therefore, using techniques to increase vein visibility, careful insertion site selection, developing optimal age specific technique though trainings and valuing the child’s clinical antecedents are highly recommended.