Editor’s note: Joseph Smith is chief scientific officer of BD, which makes instrument systems and medical devices, including equipment for vascular access management. Views are the author’s own. 

A clinician preps a patient’s skin. They position the needle, pierce the patient’s skin and vein, and place and secure an intravenous (IV) catheter. In theory, this is a simple, possibly unremarkable procedure. However, my firsthand experience tells me how pivotal and emotional this early stage in the acute care journey can be – for both patients and their clinicians. For patients, it is often the defining moment that marks the transition to being an in-patient in a hospital and beginning their journey of recovery. For clinicians, it represents the establishment of a new and often critically important avenue for treatment. And for both, there is most often a sigh of relief when the process is over, as too often it is not so readily accomplished. 

As a physician, and specifically an interventional cardiac electrophysiologist, I have my own experience with needles. I’ve never lost sight of how needles are diagnostic and therapeutic instruments to be used with great care and only when the potential benefit to the patient exceeds any potential harm. Since that harm can take many forms, including pain, bleeding and risk of infection, everyone strives to breach the skin as few times as possible. 

That’s why I’m particularly passionate about the future of vascular access and the promise of reducing the number of “sticks” a patient will undergo during their hospital stay.

The untold reality of vascular access today

Up to 90 percent of hospitalized patients require some form of IV access. Peripheral IV catheters are the most common vascular access devices used – in fact, inserting a peripheral IV is one of the most frequently performed invasive procedure in hospitals with about 2 billion placed annually worldwide. These devices are preferred for the short-term delivery of IV fluids, medications, blood products and contrast media. But despite placement of peripheral IV catheters being a regular daily occurrence, problems are all too common. 

Initial insertion success rates for placing a peripheral IV hover around only 70 percent. Up to half of these devices fail from unnecessary and preventable complications that require treatment and the insertion of a new catheter. And, nearly two-thirds of patients are considered “difficult sticks,” and may need multiple attempts and even support from other clinicians to place the IV. 

Today’s experience with peripheral IVs is ripe for meaningful innovation. 

The opportunity is even larger when you consider that even after the catheter is successfully placed, it’s not ideal for all uses. Blood draws from peripheral IVs are known to yield poor sample quality. That’s why, if you or a loved one have ever been in the hospital, one of the less pleasant experiences may have been being awakened by a nurse or phlebotomist in the pre-dawn hours needing to “stick” you and draw blood from a separate access point for a diagnostic test, even though you already had a functioning IV catheter. And, like IV placements, blood draws often require multiple attempts for success.

Add to all of this the prominent prevalence of needle phobia – more than 60 percent of the population in a recent international survey – and you see the emotional toll this can take on both the patient being “stuck” to the clinician ordering or performing such “sticks.”  

Changing the status quo of vascular care

While IV catheters are a workhorse of patient care today, there is a clear path for better and more compassionate care. 

There are several practices that clinicians can adopt to reduce the impact of needle sticks in a clinical setting, including:

• Driving successful placement of the IV on the first attempt to eliminate repeat or failed "sticks" through intuitive technologies like ultrasound placement. 
• Advocating to use the IV line as a single access point for all required therapies and blood draws to eliminate the need for multiple draws.
•  Ensuring clinical guidelines are in place that optimize the maintenance of an IV line, and ultimately, reduce the risk of infection. 

Clinicians can (and should) play a role in advocating for elevated clinical practice and guidelines. That’s how we’ll drive meaningful change for the two most frequent medical procedures, blood draw and IV insertion.