Original Article: PDF OnlyNeonatal Vascular Access Practice and Complications An Observational Study of 1,375 Catheter DaysMcIntyre, Colette MNurs; August, Deanne GradCirt; Cobbald, Linda RM; Lack, Gill RM; Takashima, Mari MEpi; Foxcroft, Katie MAppSci; Marsh, Nicole PhD; Smith, Patricia MNurs; New, Karen PhD; Koorts, Pieter FRACP; Irwin, Adam PhD; Ullman, Amanda PhD Author Information Women's and Newborns Service, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia (Mss McIntyre, August, Cobbald, Lack, Foxcroft, and Smith and Mr Koorts); Alliance for Vascular Access Teaching and Research (AVATAR), Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia (Mss August and Takashima and Dr Ullman); School of Nursing and Midwifery, Griffith University, Nathan, Queensland, Australia (Ms August and Dr Ullman); UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia (Ms Foxcroft); Nursing and Midwifery Centre for Research, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia (Drs Marsh, New, and Ullman); School of Nursing, Midwifery and Social Work, University of Queensland, St Lucia, Queensland, Australia (Drs Marsh, New, and Ullman); Children's Health Queensland and the University of Queensland, Brisbane, Queensland, Australia (Drs Irwin and Ullman); and School of Nursing, Queensland University of Technology, Kelvin Grove, Australia (Dr Marsh). Corresponding Author: Amanda Ullman, PhD, Centre for Children's Health Research, The University of Queensland and Children's Health Queensland, Brisbane, Queensland, Australia ([email protected]). Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jpnnjournal.com). This project was funded by the Royal Brisbane and Women's Hospital Foundation. Thank you to the neonates, parents, caregivers, and clinicians who generously participated in this study. Disclosure: AU reports investigator-initiated research grants and speaker fees provided to her previous employer, Griffith University, from 3M Medical, Becton Dickinson, and Cardinal Health (unrelated to the current project). NM's previous employer Griffith University has received on her behalf investigator-initiated research grants from Becton Dickinson, and Cardinal Health and a consultancy payment provided to Griffith University from Becton Dickinson for clinical feedback related to catheter placement and maintenance (unrelated to the current project). DA reports and speaker fees provided to Griffith University from 3M Medical (unrelated to the current project). Disclosure: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Each author has indicated that he or she has met the journal's requirements for Authorship. Submitted for publication: April 23, 2020; accepted for publication: April 22, 2021. The Journal of Perinatal & Neonatal Nursing: February 11, 2022 - Volume - Issue - doi: 10.1097/JPN.0000000000000589 Buy SDC PAP Metrics Abstract Vascular access devices play vital roles within neonatal care. We aimed to identify neonatal vascular access device insertion and management practices, and describe the incidence and risk factors for complication development. This is a prospective cohort study of neonates requiring vascular access devices over 3 months in an Australian quaternary-referral neonatal intensive care unit. In addition to describing current practices, primary outcomes were device failure, complications, and skin complications. Results are reported using descriptive statistics and with risk factors calculated via Cox proportional hazards regression. A total of 104 neonates required 302 vascular access devices, over 1375 catheter days. Peripheral intravenous catheters (PIVCs) were most used (n = 186; 62%), followed by umbilical venous catheters (n = 52; 17%). Insertion attempts were often undocumented; but for those recorded, 5% of devices (n = 15) required 4 attempts or more. Device failure occurred in 28% (n = 82), at an incidence rate of 62.5 per 1000 catheter days (95% confidence interval [CI] 49.7-75.9). Failure was most frequent in PIVCs (37%; n = 68), peripheral arterial catheters (33%; n = 2), and peripherally inserted central catheters (20%; n = 6). Infiltration and extravasation were the most frequent cause of PIVC failure (12%; n = 35). A birth weight less than 1500 g was associated with a significant decrease in PIVC failure (hazard ratio 0.58; 95% CI 0.34-0.99). Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.