This study aimed to investigate the success of first-time phlebotomy and the affecting factors in children between 4 and 10 years of age.
Methods:
This descriptive, comparative, and cross-sectional study was conducted on 155 children who underwent phlebotomy. The Sociodemographic Data Form, the Children’s Anxiety Meter–State, the Children’s Fear Scale, and the Difficult Intravenous Access score were used to collect the data for the study. The relationship between the success of first-time phlebotomy, mean pre-phlebotomy fear and anxiety score, and Difficult Intravenous Access score were examined. The variables affecting the success of first-time phlebotomy were assessed by regression analysis.
Results:
Phlebotomies failed in 18.1% of children. A statistically significant relationship was found between the success of first-time phlebotomy, Children’s Anxiety Meter–State, Children’s Fear Scale mean scores assessed by the researchers, and Difficult Intravenous Access score. Factors affecting the success of first-time phlebotomy include difficult vascular access, age, mean Children’s Anxiety Meter–State score, mean Difficult Intravenous Access score, and duration of the last phlebotomy performed. These factors explain 42% of the total factors affecting the success of first-time phlebotomy.
Conclusion:
Child’s fear, anxiety before phlebotomy, and difficult vascular access affects the first-time phlebotomy success.
Da SilvaJRSPizzoliLMLAmorimARet al. Using therapeutic toys to facilitate venipuncture procedure in preschool children. Pediatr Nurs2016; 42(2): 61–68.
2.
SahinerNCİnalSSevim AkbayA. The effect of combined stimulation of external cold and vibration during immunization on pain and anxiety levels in children. J Perianesth Nurs2015; 30(3): 228–235.
3.
AydinDSahinerNC. Effects of music therapy and distraction cards on pain relief during phlebotomy in children. Appl Nurs Res2017; 33: 164–168.
4.
AydinDSahinerNCCiftciEK. Comparison of the effectiveness of three different methods in decreasing pain during venipuncture in children: ball squeezing, balloon inflating and distraction cards. J Clin Nurs2016; 25(15–16): 2328–2335.
5.
İnalSKelleciM. Relief of pain during blood specimen collection in pediatric patients. MCN Am J Matern Child Nurs2012; 37(5): 339–345.
6.
RisawLNarangKThakurJSet al. Efficacy of flippits to reduce pain in children during venipuncture—a randomized controlled trial. Indian J Pediatr2017; 84(8): 597–600.
7.
HedénLvon EssenLLjungmanG. The relationship between fear and pain levels during needle procedures in children from the parents’ perspective. Eur J Pain2016; 20(2): 223–230.
8.
SahinerNCBalMD. The effects of three different distraction methods on pain and anxiety in children. J Child Health Care2016; 20(3): 277–285.
9.
AponteHAcostaSRigamontiDet al. The use of ultrasound for placement of intravenous catheters. AANA J2007; 75(3): 212–216.
CarrPJRippeyJCRBudgeonCAet al. Insertion of peripheral intravenous cannulae in the Emergency Department: factors associated with first-time insertion success. J Vasc Access2016; 17(2): 182–190.
12.
LegemaatMCarrPJvan RensRMet al. Peripheral intravenous cannulation: complication rates in the neonatal population: a multicenter observational study. J Vasc Access2016; 17(4): 360–365.
13.
CuperNJde GraaffJCvan DijkATHet al. Predictive factors for difficult intravenous cannulation in pediatric patients at a tertiary pediatric hospital. Pediatr Anesth2012; 22(3): 223–229.
14.
JacobsonAFWinslowEH. Variables influencing intravenous catheter insertion difficulty and failure: an analysis of 339 intravenous catheter insertions. Hear Lung2005; 34(5): 345–359.
15.
LarsenPEldridgeDBrinkleyJet al. Pediatric peripheral intravenous access: does nursing experience and competence really make a difference?J Infus Nurs2010; 33(4): 226–235.
YenKRiegertAGorelickMH. Derivation of the DIVA score: a clinical prediction rule for the identification of children with difficult intravenous access. Pediatr Emerg Care2008; 24(3): 143–147.
18.
RikerMWKennedyCWinfreyBSet al. Validation and refinement of the difficult intravenous access score: a clinical prediction rule for identifying children with difficult intravenous access. Acad Emerg Med2011; 18(11): 1129–1134.
McMurtryCMNoelMChambersCTet al. Children’s fear during procedural pain: preliminary investigation of the Children’s Fear Scale. Health Psychol2011; 30(6): 780–788.
21.
McKinleySMadronioC. Validity of the Faces Anxiety Scale for the assessment of state anxiety in intensive care patients not receiving mechanical ventilation. J Psychosom Res2008; 64(5): 503–507.
22.
Özalp GerçekerGAyarDÖzdemirEet al. Gaining of Children’s State Anxiety and Children’s Fear Scale to Turkish language. Dokuz Eylül Üniv Hemşire Fak Elektron Derg2018; 11(1): 9–13.
23.
KleiberCMccarthyAM. Evaluating instruments for a study on children’s responses to a painful procedure when parents are distraction coaches. J Pediatr Nurs2006; 21(2): 99–107.
24.
ErsigALKleiberCMcCarthyAMet al. Validation of a clinically useful measure of children’s state anxiety before medical procedures. J Spec Pediatr Nurs2013; 18(4): 311–319.
25.
Özalp GerçekerGGümüşMYardımcıFet al. Psychometric properties of the Turkish version of the difficult intravenous access score for children. Dokuz Eylül Üniv Hemşire Fak Elektron Derg2017; 10(3): 153–158.
26.
HeinrichsJFritzeZVandermeerBet al. Ultrasonographically guided peripheral intravenous cannulation of children and adults: a systematic review and meta-analysis. Ann Emerg Med2013; 61(4): 444–454.e1.
27.
SzmukPSteinerJPopRBet al. The VeinViewer vascular imaging system worsens first-attempt cannulation rate for experienced nurses in infants and children with anticipated difficult intravenous access. Anesth Analg2013; 116(5): 1087–1092.
28.
PetersonKAPhillipsALTruemperEet al. Does the use of an assistive device by nurses impact peripheral intravenous catheter insertion success in children?J Pediatr Nurs2012; 27(2): 134–143.
29.
HessHA. A biomedical device to improve pediatric vascular access success. Pediatr Nurs2010; 36(5): 259–263.
30.
NoelMMcMurtryCMChambersCTet al. Children’s memory for painful procedures: the relationship of pain intensity, anxiety, and adult behaviors to subsequent recall. J Pediatr Psychol2010; 35(6): 626–636.
31.
UmanLSBirnieKANoelMet al. Psychological interventions for needle-related procedural pain and distress in children and adolescents. Cochrane Database Syst Rev2013(10): CD005179.
32.
WenteSJK. Nonpharmacologic pediatric pain management in emergency departments: a systematic review of the literature. J Emerg Nurs2013; 39(2): 140–150.
ChambersCTJohnstonC. Developmental differences in children’s use of rating scales. J Pediatr Psychol2002; 27(1): 27–36.
35.
CarlsonKLBroomeMVesseyJA. Using distraction to reduce reported pain, fear, and behavioral distress in children and adolescents: a multisite study. J Soc Pediatr Nurses2000; 5(2): 75–85.
36.
LapostolleFCatineauJGarrigueBet al. Prospective evaluation of peripheral venous access difficulty in emergency care. Intensive Care Med2007; 33(8): 1452–1457.
