Paediatric invasive device utility and harm: a multi-site point prevalence survey

Background

Invasive devices are widely used in healthcare settings and are essential for managing and treating patients; however, paediatric patients are especially vulnerable to invasive device-associated harm. This study aimed to explore invasive device utility, prevalence, harm, and clinical practice across three Australian paediatric tertiary hospitals.

Study Design

A multicentre, observational, rolling point prevalence survey was conducted across three Australian paediatric tertiary hospitals (Queensland Children’s Hospital, Perth Children’s Hospital and the Royal Children’s Hospital in Melbourne). Fifty per cent of inpatients were systemically sampled by random allocation. Patients with devices were then followed for up to 3-days for device-related complications/failures and management/removal characteristics.

Study Results

Of the 285 patients audited, 78.2% had an invasive device (n = 412 devices), with a median of 1 device-per-patient (interquartile range 1–2), with a maximum of 13 devices-per-patient. Over half of the devices were vascular access devices (n = 223; 54.1%), followed by gastrointestinal devices (n = 112; 27.2%). The point-prevalence of all device complications on Day 0 was 10.7% (44/412 devices) and period-prevalence throughout the audit period was 27.7% (114/412 devices). The period-prevalence of device failure was 13.4% (55/412 devices).

Conclusions

There is a high prevalence of invasive devices used among hospitalised paediatric patients, with device utilisation rates varying across different hospital settings. One in ten devices failed within the audit period. The high prevalence of complications, coupled with the commonality of vascular access devices, highlights the importance of management measures and ongoing surveillance to minimise the risk of all complications.