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Background: Healthcare consumers require diverse resources to assist their navigation of complex healthcare interactions, however, these resources need to be fit for purpose. Aim: In this study, we evaluated the utility, usability and feasibility of children, families and adults requiring long‐term intravenous therapy using a recently developed mobile health application (App), intravenous (IV) Passport. Design: Multi‐site, parallel, multi‐method, prospective cohort study. Methods: A multi‐site, multi‐method study was carried out in 2020–2021, with 46 participants (20 adults, 26 children/family) reporting on their experiences surrounding the use of the IV Passport for up to 6 months. Results: Overall, utility rates were acceptable, with 78.3% (N = 36) using the IV Passport over the follow‐up period, with high rates of planned future use for those still active in the project (N = 21; 73%), especially in the child/family cohort (N = 13; 100%). Acceptability rates were high (9/10; IQR 6.5–10), with the IV Passport primarily used for documenting new devices and complications. Thematic analysis revealed three main themes (and multiple subthemes) in the qualitative data: Advocacy for healthcare needs, Complexity of healthcare and App design and functionality. Conclusion: Several recommendations were made to improve the end‐user experience including 'how to' instructions; and scheduling functionality for routine care. Implications for the Profession and/or Patient Care: The IV Passport can be safely and appropriately integrated into healthcare, to support consumers. Impact: Patient‐/parent‐reported feedback suggests the Intravenous Passport is a useful tool for record‐keeping, and positive communication between patients/parents, and clinicians. Reporting Method: Not applicable. Patient Contribution: Consumers reported their experiences surrounding the use of the IV Passport for up to 6 months. [ABSTRACT FROM AUTHOR]

Background: Despite pervasive need for peripheral intravenous catheters, insertion is often difficult, and approximately two thirds fail prematurely. Midline catheters are an alternative long peripheral catheter, inserted in the upper arm, ideal for patients with difficult access. Aim: The aim of this study is to test feasibility of the protocol and compare the efficacy and safety of midline catheters to peripheral intravenous catheters. Design: A parallel‐group, pilot randomized controlled trial of adult medical/surgical hospitalized patients, from a single Australian referral hospital. Methods: Participants with difficult vascular access (≤2 palpable veins) and/or anticipated ≥5 days of peripherally compatible intravenous therapy were recruited between May 2019 and March 2020. Participants were randomized to (1) peripheral intravenous catheter or (2) midline catheter. Primary feasibility outcome measured eligibility, recruitment, protocol adherence, retention and attrition. Primary clinical outcomes measured device insertion failure and post‐insertion failure. Results: In total, n = 143 participants (71 peripheral intravenous catheters and 72 midline catheters) were recruited; n = 139 were analysed. Most feasibility criteria were met. Peripheral intravenous catheters had shorter functional dwell time, with higher incidence of post‐insertion failure compared to midline catheters. Conclusion: Midline catheters appear to be superior for patients with difficult vascular access or receiving prolonged intravenous therapy; a large, multi‐centre trial to confirm findings is feasible. Summary statement: What is already known about this topic? Peripheral intravenous catheters have endemically high incidence of complications.Midline catheters have been proposed as an alternative peripheral intravenous device, following recent advancements in catheter material and design.Few studies have compared safety and efficacy of contemporary midline catheters with peripheral intravenous catheters. What this paper adds: Midline catheters had a longer functional dwell time and lower incidence of post insertion‐failure, compared to peripheral intravenous catheters.Midline catheters appear safe; however, inserter skill appears to have critical influence on insertion success. The implications of this paper: This study established the feasibility and importance of a large, multicentre, randomized controlled trial to confirm findings.Future research should also focus on financial impacts, including cost‐efficiency.Policy makers should consider training specialist inserters to place midline catheters. [ABSTRACT FROM AUTHOR]

Background: Childbirth is a normal, physiological process, yet intervention is common. Arguably the most common intervention is the insertion of a peripheral intravenous catheter; however, there are few studies guiding best practice. This study aimed to describe current intravenous catheter insertion practice, explore clinician decision‐making during insertion and perceptions of women. Methods: This prospective, observational cohort study recruited 101 women and clinicians from two Australian regional hospitals. Data collection incorporated non‐participant observation, brief interview and chart review. Variables measured included pain score, insertion attempts, catheter gauge and dwell time. Results: Childbearing women were, on average, aged 31 with body mass index (BMI) above 28. Women reported a mean pain score of 3.3/10 at 24 h for catheter insertion and 12% reported bruising. An 18‐gauge catheter was considered more painful than a 16‐gauge, and multiple attempts did not increase perceived average pain score. Association between failed first attempts and higher BMI was not established. Participant clinicians were predominantly midwives, who selected and placed 18‐gauge catheters mostly in hand or wrist (66%). Decision‐making about site, catheter gauge, dressing and attempts varied. Thirty‐four per cent attempted two to three times, despite regular practise. Confidence to reliably insert determined catheter gauge and almost half clinician participants cited hospital policy and preferred non‐dominant arm as key reasons for the location of PIVC. Conclusions: Regular use of a large‐gauge catheter is counter intuitive when placed in the small veins of the hand with extension tubing. More research is needed to promote best practice around gauge selection, site and women's experience. [ABSTRACT FROM AUTHOR]