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Midline venous catheters as an alternative to central line catheter placement: a product evaluation

22 April 2021
Volume 30 · Issue 8


Midline catheters have emerged as a successful alternative to peripheral venous catheters (PVCs) and central venous catheters (CVCs) in select patients. Midline catheters allow for greater duration of access when compared with PVCs and avoid the critical complications associated with CVCs. This article describes the implementation of the Powerwand® midline at a large paediatric tertiary care facility in acute and intensive care settings, and presents illustrative cases of the catheter in use. Product evaluation was performed by a paediatric vascular access team of registered nurses and included information on patient outcomes, inserter satisfaction, patient satisfaction, and cost effectiveness.

A peripheral venous catheter (PVC) is the most common vascular access device (VAD) used for short-term therapies. For various reasons, some patients may be unable to sustain a PVC for the duration of therapy, yet do not meet criteria for CVC placement. Chopra et al (2015) determined that peripherally inserted central catheters (PICCs), a type of CVC, were overused in 43% of patients, and midline catheters would have been a more appropriate VAD selection, based on clinical indications. Selecting the appropriate VAD involves multiple factors: patient diagnosis, length of therapy, quality of vascular access, type of infusate (irritant or vesicant), and amount of medications to be administered intravascularly (Anderson et al, 2016). In addition, reducing the incidence of central line-associated bloodstream infections (CLABSI) is both a patient safety and cost saving imperative for healthcare organisations. For every 1000 in-hospital CLABSI cases, there are 150 excess deaths; each CLABSI event is estimated to cost $48 108 (Agency for Healthcare Research and Quality (AHRQ), 2017).

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