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American Academy of Pediatrics
Research Articles

Resource Utilization and Cost of Inserting Peripheral Intravenous Catheters in Hospitalized Children

David A. Goff, Pamela Larsen, Jason Brinkley, David Eldridge, Dale Newton, Timothy Hartzog and J. Routt Reigart
Hospital Pediatrics July 2013, 3 (3) 185-191; DOI: https://doi.org/10.1542/hpeds.2012-0089
David A. Goff
1Department of Pediatrics, Brody School of Medicine, and
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Pamela Larsen
1Department of Pediatrics, Brody School of Medicine, and
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Jason Brinkley
2Department of Biostatistics, College of Allied Health, East Carolina University, Greenville, North Carolina; and
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David Eldridge
1Department of Pediatrics, Brody School of Medicine, and
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Dale Newton
1Department of Pediatrics, Brody School of Medicine, and
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Timothy Hartzog
3Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
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J. Routt Reigart
3Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina
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Abstract

Objective: The goal of this study was to measure the costs and difficulty in placing peripheral intravenous (IV) catheters in hospitalized children; measures of resource utilization. We measured the costs and difficulty in placing peripheral intravenous (IV) catheters in hospitalized children. This common procedure has implications for the utilization of hospital resources.

Methods: This was a prospective, large-scale observational study in 2 southeastern US pediatric teaching hospitals evaluating 592 children needing peripheral IV catheters in the inpatient setting. The median age was 2.25 years with an age range of 2 days to 18 years. Costs were estimated by using directly measured staff time and national salary data. Analyses included costs according to patient characteristics (age, weight, dehydration, and difficulty of stick attempts), and nurse characteristics (experience in years and anticipated difficulty).

Results: The median cost of the pediatric IV insertions was $41, and 60% of the placements were obtained with the first nurse. Seventy-two percent of the children had a successful IV insertion in 1 to 2 attempts and accounted for 53% of total costs. However, the 28% of children who required ≥3 IV attempts had a cost range of $69 to more than $125, and they consumed 43% of the total IV costs. This subset was often <2 years old or dehydrated (P = .0002).

Conclusions: The insertion of peripheral IV catheters in an inpatient setting can be time intensive and requires significant skill. Our study suggests that resource utilization may improve when nurses and personnel proficient in starting peripheral IV catheters are used when the initial nurse has failed to obtain IV access. This systems improvement should result in shortened time to administration of parenteral therapies, positively improving outcomes and lessening length of stay, as well as improving patient/family satisfaction due to reduced perceptions of pain.

  • health care costs
  • hospitalized children
  • medical costs
  • medical cost-effectiveness
  • medical efficiency
  • peripheral IV catheters
  • Abbreviations:
    IV
    intravenous
    • Copyright © 2013 by the American Academy of Pediatrics
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    Hospital Pediatrics: 3 (3)
    Hospital Pediatrics
    Vol. 3, Issue 3
    1 Jul 2013
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    Resource Utilization and Cost of Inserting Peripheral Intravenous Catheters in Hospitalized Children
    David A. Goff, Pamela Larsen, Jason Brinkley, David Eldridge, Dale Newton, Timothy Hartzog, J. Routt Reigart
    Hospital Pediatrics Jul 2013, 3 (3) 185-191; DOI: 10.1542/hpeds.2012-0089

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    Resource Utilization and Cost of Inserting Peripheral Intravenous Catheters in Hospitalized Children
    David A. Goff, Pamela Larsen, Jason Brinkley, David Eldridge, Dale Newton, Timothy Hartzog, J. Routt Reigart
    Hospital Pediatrics Jul 2013, 3 (3) 185-191; DOI: 10.1542/hpeds.2012-0089
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    Keywords

    • health care costs
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