Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Implementation of a Vascular Access Specialist Team in a Tertiary Hospital: A Cost-Benefit Analysis

Version 1 : Received: 26 May 2023 / Approved: 29 May 2023 / Online: 29 May 2023 (09:58:33 CEST)

A peer-reviewed article of this Preprint also exists.

Ricou Ríos, L.; Esposito Català, C.; Pons Calsapeu, A.; Adroher Mas, C.; Andrés Martínez, I.; Nuño Ruiz, I.; Castellà Creus, M.; Castellà Fàbregas, L.; García Quesada, M.J.; Estrada Cuxart, O.; et al. Implementation of a Vascular Access Specialist Team in a Tertiary Hospital: A Cost-Benefit Analysis. Cost Effectiveness and Resource Allocation 2023, 21, doi:10.1186/s12962-023-00464-6. Ricou Ríos, L.; Esposito Català, C.; Pons Calsapeu, A.; Adroher Mas, C.; Andrés Martínez, I.; Nuño Ruiz, I.; Castellà Creus, M.; Castellà Fàbregas, L.; García Quesada, M.J.; Estrada Cuxart, O.; et al. Implementation of a Vascular Access Specialist Team in a Tertiary Hospital: A Cost-Benefit Analysis. Cost Effectiveness and Resource Allocation 2023, 21, doi:10.1186/s12962-023-00464-6.

Abstract

Background: The use of peripherally inserted central catheters and midline catheters is growing due to their potential benefits. These devices can increase patient safety and satisfaction while reducing the use of resources. As a result, many hospitals are establishing vascular access specialist teams staffed by nurses who are trained in the insertion and maintenance of these catheters. Objective: Evaluate ex-ante whether the benefits of replacing peripheral venous catheters, peripherally inserted central catheters and midline catheters with ultrasound-guided peripherally inserted central catheters and midline catheters by a vascular access specialist team outweigh their costs. Methods: Cost-benefit analysis from the perspective of the healthcare provider based on administrative data. The study estimates the reduction in resources used when replacing peripherally inserted central catheters, midline catheters and peripheral venous catheters with ultrasound-guided peripherally inserted central catheters and midlines, as well as the additional resources required for their use. Results: Each ultrasound-guided peripherally inserted central catheter replacing a peripherally inserted central catheter, results in a measurable resource reduction of approximately €31. When 3 peripheral venous catheters are replaced by an ultrasound-guided peripherally inserted central catheter, the saving is €63. Similarly, each ultrasound-guided midline catheter replacing a midline, results in a reduction of €16, while each ultrasound-guided midline catheter replacing 3 peripheral venous catheters results in a reduction of €96. Conclusion: The benefits of replacing peripheral venous catheters, peripherally inserted central catheters and midline catheters by introducing a vascular access specialist team trained in the implantation of ultrasound-guided peripherally inserted central catheters and midline catheters, outweigh its cost mainly because of the decrease in hospital stay due to the lowered risk of healthcare-associated infections. These results motivate the implementation of the service, adding to previous experience suggesting that it is also preferable from the point of view of patient safety and satisfaction.

Keywords

Catheters; Cost Benefit Analysis; Economic evaluation; Healthcare-associated infections; Nursing care; Peripherally Inserted Central Catheter; Peripheral Venous Catheters; Ultrasound.

Subject

Public Health and Healthcare, Nursing

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