A Descriptive Study of Vascular Access Devices Among Adult and Pediatric Home Infusion Patients

Introduction The Infusion Nurses Society recommends selecting the optimal vascular access device (VAD) for the therapy plan. These recommendations are primarily driven to identify peripheral vs. central vascular access based on infusate properties, the frequency and duration of infusions, unique patient features, and resources available. The objectives of this study are to describe the utilization of VADs in the home infusion setting and identify trends in specific medication treatments and patient populations. Methods This study is a descriptive, retrospective review of patient data collected by the National Home Infusion Foundation for its benchmarking program. Throughout 2021 and 2022, 12,968 patient cases were de-identified and submitted using a formatted Excel® file. The patient cases were to include status at discharge, age, type of VAD, and if applicable adverse drug reaction. For the patient case to be eligible for this study, VAD, patient age, and therapy type data had to be included. The data was analyzed using IBM Analytics Software, Statistical Product and Service Solutions. Frequency and percentages were determined for patient age group and therapy type while cross tabulation analysis was used to gain an in-depth understanding of the VAD usage for the different home infusion therapies. Results The final data set included 10,967 patient cases and was analyzed to determine the patient demographics, most common type of home infusion VAD, and the type of devices used with the different therapy types. In almost two-thirds (n=7,193) of the patient cases, a peripherally inserted central catheter (PICC) was used as the therapy access device. A midline was used as the VAD in 13.12% of the cases, and a peripheral access device in 8.59% of the cases. Conclusion In this study of VAD utilization in the home infusion setting, PICC was reported in two-thirds of all patients included. When analyzed by therapy type, PICC was reported as the primary VAD for the administration of parenteral nutrition, antiinfectives, and inotrope therapies. The high utilization of PICCs in this study validates its selection for medication administration in the home site of care.