How to improve first-attempt peripheral IV catheter placement success
Abstract:
Purpose: This study aims to evaluate the effects of toy-mediated hand squeezing or palpation techniques on the success of peripheral IV catheter placement in pediatric hematology and oncology patients.
Methods: This study was designed and conducted as a three-arm randomized controlled trial to improve peripheral intravenous catheter placement success. Pediatric hematology and oncology patients aged 7-17 years were randomly assigned to a squishy toy group (n = 30), a palpation group (n = 30), or a control group (n = 30). Before inclusion in the study, each patient was assessed using the Difficult Intravenous Access (DIVA) score. Additionally, demographic and clinical data were collected through the demographic information form and the catheter documentation form.
Results: The study participants had a mean age of 11.3 years (SD = 2.7), and 50 % were male. The first-attempt success rate of peripheral IV catheter insertion was significantly higher in the intervention groups using the squishy toy squeezing and palpation technique than in the control group (χ2 = 23.080, p < 0.001). Both the squishy toy and palpation groups required significantly fewer attempts for peripheral IV catheter insertion than the control group (F = 8.692, p < 0.001). Both intervention groups required significantly less time for the procedure than the control group (F = 3.373, p < 0.05).
Conclusion: This three-arm study demonstrated that squishy toy squeezing and palpation techniques improve first-attempt peripheral IV catheter placement success, reduce insertion attempts and procedure time, and minimize complications in pediatric hematology and oncology patients with DIVA.
Trial registration: The research was registered on ClinicalTrials.gov under the identifier number (NCT07041216). https://clinicaltrials.gov/study/NCT07041216.
Reference:
Gürcan M, Say B, Yayla N, Atay Turan S. Effectiveness of toy-mediated hand squeezing or palpation in peripheral IV catheterization among pediatric hematology and oncology patients: A randomized controlled trial. Eur J Oncol Nurs. 2025 Oct 13;79:103005. doi: 10.1016/j.ejon.2025.103005. Epub ahead of print. PMID: 41166835.