The Silent Epidemic Affecting Community Health – MedCity News

I will never forget the patient. I met him at a large academic medical center at 4:15 am. He was in a small room from the emergency department where he had spent the whole night with the staff trying to find out what was going on so that he could get the right treatment. He was tired and in pain. He said that between IV tests and blood draws for lab work, he had been pricked with needles 41 times. From the look on his hands, it was clear he wasn’t exaggerating. And now, the phlebotomist I was with was about to stick him for the second time since we arrived.

Unfortunately, this type of incident can be very common. Peripheral IV insertion and blood collection are two of the most common patient procedures in US hospitals, with up to 90 percent of patients requiring an IV catheter and requiring, on average, two collections of blood per day. A recent Harris Poll revealed eye-opening facts about repeated needlestick challenges in hospitals. More than half of Americans have had multiple needlestick tests during IV placement and 71 percent during blood draws. In fact, 11 percent of recent hospital patients reported needing ten or more stitches for a blood transfusion.

The survey found that more than 9 out of 10 nurses believe that repeated needle sticks affect the patient experience in the hospital. But in addition to an unsatisfactory experience for patients and doctors, these methods can cause complications, increased costs and longer hospital stays. They may also increase the risk of venous insufficiency or the loss of veins suitable for treatment due to damage to existing or previous venous access devices or punctures.

And the challenge is even greater for the nearly two-thirds of adults with intravenous access, where inserting the first IV or obtaining a blood sample often requires considerable effort. For patients who are admitted at least four times a year – which accounts for up to a quarter of all hospital patients – patients with intravenous access can receive more than 50 stitches a year.

As I think about these facts, my thoughts go back to the patient in the ER who received over 40 supplies in a matter of hours. There is a better way. We can have an incredible impact on both the patient and the doctor by promoting just these two practices. Protecting patients from venous damage and providing the best care experience requires us to reflect on our own attitudes and practices, advocate for change and take steps that support evidence-based ways to improve access efficiency.

As a paramedic and nursing student, we put IV lines in the veins that were easiest for us to use – not the best for the patient. Usually we didn’t draw up the labs when we inserted the lines and the patient would get another needle threader once they got to the hospital. Seeing the proliferation of practices that provided poor patient experience began a journey to improve patient experience and outcomes. I have learned to place IVs away from puncture sites, such as the arm and elbow, where the risk of complication and replacement is high. The phlebotomists helped me learn how to draw blood correctly, so as not to hemolyze, and what tubes are needed. This helped me to avoid pulling the patient again. Finally, I learned how to use technology like near infrared and ultrasound to improve my chances of success on the first stick. And I became interested in finding ways to reduce stress.

However, to achieve a widespread impact that actually helps raise the standard of care, we must educate and train clinical staff to accurately assess the patient’s neurological health and acquire the knowledge and tools needed to help with success on the first attempt. If the patient reports having a difficult access to the vein, instead of trying multiple placement tests ourselves, we can call in an experienced team with advanced skills and equipment that can be placed quickly and efficiently with fewer needle sticks, less wasted time and less delay. in care.

To help maintain vessel health, we need to use new techniques designed to reduce vessel trauma from IV insertion, IV replacement, and repeated blood transfusions and draws. again. These include:

• Ultrasound-guided placement and needle tracking devices can help reduce the amount of effort and time to achieve a successful vessel.
• Specialized needle-free blood collection devices designed to use peripheral IV catheters for blood collection reduce punctures and help improve the patient experience.

As we embrace and advocate for these new and improved standards of care, we can move from “the way we’ve always done it,” to a more compassionate and effective approach with less effort. of placing or changing the IV and reducing recurrence. needle sticks for drawing blood and drawing again.

It’s time to change the practice for the better – for us as doctors, our patients, their families and their loved ones.

Photo: kuarmungadd, Getty Images

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