By Jessica Cohen
March 23, 2019
It’s not uncommon for medical staff to wake patients in the early hours of the morning to prick them for a blood draw. It’s a reality that Centura Health is trying to change.
“What a rude way to wake up,” said Rhonda Ward, chief nursing officer for Centura’s south Denver group. “A bright light and a needlestick.”
Nurses at Littleton Adventist Hospital now connect a blood-draw tool—a flexible catheter called PIVO—to a patient’s existing peripheral intravenous line to extract blood samples directly from the vein, without any additional needle pricks.
A clinically integrated supply chain team at Centura began researching the PIVO system last May, and even sent two nurses and members of the health system’s laboratory and supply chain leadership to Intermountain Healthcare in Salt Lake City to see the tool in action. Intermountain uses PIVO at all 22 of its hospitals.
“It adds no pain to the patient,” Ward said. “Unfortunately, nurses, just by nature of their work, have to create discomfort in some of the things that they have to do. So not creating more pain for the patient has been a big satisfier.”
Centura plans to roll out the PIVO systemwide, deploying the tool at all 17 of its hospitals by the end of 2019. At the three hospitals that have already gone live, the tool is now the standard of care for most inpatients’ routine lab work.
PIVO, which received 510(k) clearance from the Food and Drug Administration in 2017, is now used in “dozens” of hospitals and health systems, according to Velano Vascular CEO Eric Stone.
But Diane Robertson, director of the ECRI Institute’s health technology assessment program, noted that evidence of PIVO’s clinical benefits is still scarce.
There are a handful of peer-reviewed studies that demonstrate positive patient outcomes—one 2018 study in the journal Practical Laboratory Medicine found blood draws with PIVO had a lower risk of some types of sample degradation—but much of the available evidence takes the form of conference abstracts, white papers published by the manufacturer and studies with small sample sizes.
“All of these studies would suggest that additional study would be warranted,” Robertson said. “But while the evidence is inconclusive at this point on a number of the potential benefits, in studies and in our look at safety information there’s been no indication that there’s been any harm from this technology.”
She added, “It’s reasonable for hospitals to consider it; it goes back to weighing the patient-oriented outcomes.”
Stone said he expects a “regular cadence of further data” regarding PIVO’s outcomes to be released in the next year, including peer-reviewed studies, conference presentations and white papers.
“There are published articles out there,” he said, citing studies out of the University of Pennsylvania and Brigham and Women’s Hospital. “With any new technology and novel procedure, it takes important work, effort and thought on the part of partner organizations and clinical collaborators to assess long-term sustainability.”
At Littleton Adventist, PIVO led to a marked increase in patient satisfaction, Ward said. She cited responses to an internal survey sent to patients through Press Ganey, which found the hospital boasts an 84.8 rating on “Degree all staff showed compassion” as of January, compared with a 71.4 rating when the hospital started the PIVO trial in July.
Centura staff expected patients would appreciate fewer punctures. But another positive outcome has been improvements in employee safety, according to Karla Barber, Centura’s director of value analytics. No employees at Littleton Adventist have reported needlesticks related to lab draws since the facility deployed PIVO, primarily because the hospital has cut down the amount of needles required in patient care.
“By taking the needle out of the healthcare continuum, (our hospitals) are already pushing to almost 30,000 needles that have been removed from patient care,” Barber said.