We recently switched from the PROTETIV catheter and a j-loop to the Nexiva system. The hospital says it's for patient safety, less blood exposure of staff, reduction of infection for patients, and cost. The Nexiva costs 4.80 where the Protectiv was about 1.50 and then the j-loop.
The hospital also told the staff the nurses in CT wanted something better for the Power injector.
This new product was barely trialed in our institution by only a few departments with some positive feedback. When it was launched to the rest of the hospital after a few demo's on rubber tubing, the old product was removed without anyone mastering the new. This is a huge issue as since June, there have been patients who have been stuck anywhere up to 9-13 times with this new product, a patient suffered severe extravasations post Gad injection with this product when a blood return was evident, sites are red and inflamed less than 24 hours after insertion. So here you have 4.80 x's 13= 62.40 just for multiple sticks.
My ratio has been only 3 successful starts. My co-workers most who are also IV proficient are also unable to have successful attempts. The company educators still rounding informing us our techniques are poor; this is the product you're going to have so get over it, etc... This is not very cost effective to continue paying a company to educate when the staff is not able to use it. Any new medical product that takes this long to master...and it's still not does not belong.
The ambulance company we use does not use these either as upon trial they were unsuccessful during emergencies and they kept the product we use to use.
Patients are scream upon insertion as this new product is extremly painful upon insertion; and patients being injected now for nuclear medicine complain of pain. The MD's don't want this product either.
This product has had multiple recalls per the FDA, yet it remains.
What upsets me most and I have stated it to the IV reps are patients are being placed in harms way not only from multiple IV attempts but from the continued introduction of staph from multiple skin punctures with lead to Blood Bourme Pathogens such as MRSA. It sickens me to think anyone would ever allow this in-humane treatment continue. I myself at this point stopped placing lines sue to this product. My general rule has only been 2, perhaps 3 in an emergency situation and then I'm done.
I have an extensive background in peds, although I am now in Critical Care. I know the peds nurses are also having difficulty~~~happy I'm not in peds anymore.
Contrary to your experience, I actually enjoy placing the device. The patients comments have been that the stylet seems sharper and therefore it doesn't hurt as much. There is definitely a learning curve to it but with the proper training, I think anyone could get used to it.
The FDA product recalls were probably from initial design of 2003. BD has then redesigned the product. I am not a paid speaker for BD but I can see where everyone could benefit from this product. We concluded a 3-week trial with very good results. I would like to see where you got the product recall information from and ask my BD rep about it. Thanks.
We had the EXACT same experience concerning the Nexiva catheters ! It has to make you wonder what type of sales hype is being given that these catheters are railroaded in, even after feedback states that the learning curve is long and we find them not to be patient friendly. We, on the IV team were asked to "trial" them for consideration, wrote out the paperwork with our assessment of the catheter and were told by the powers that be to "get used to them, the whole hospital will be going to them next week and all others will be removed." So much for a trial. The decision had been made long before we even knew they were coming. It took us a year to have decent skill & competency using these catheters (the IV team, the rest of the hospital & ancillary dept.'s still can't do them). We were lucky in being able to keep a small supply of our previous IV's (agreed to by product division, not the nursing supervisory staff) for those with difficult veins. My biggest complaint is the discomfort and pain caused to the patient. 90% of my patients complain that they are very painful during insertion-----the rep replied that these catheters are actually sharper than our Bard Insytes----therefore it must be our techniques, and when that improved there would be no problem. Phooie! I find them to be less manuverable, less pliant, duller & more painful. Unless I have a large straight "easy" vein I revert back to my old standby, particually in the elderly or chronicly ill patients . Let me know how your doing? I'm finally getting the hang of it but it's still not my first choice of equipment and i always have Bard Insytes on the cart. We were told not to use them on pediatric patients under the age of ?6yrs--i could be wrong on the age factor, i'd have to recheck that. so we didn't have to many problems with the pediatric population getting multiple sticks. The whole way it was presented, introduced and the forced change without proper investigation or trial----smells political to me & it stinks.
Sorry you had this problem, but you have misstated one thing. Bard does not manufacturer or sell a short peripheral IV catheter. Insyte is the trademane for the short peripheral catheter made by BD, the same manufacturer as the Nexiva. Insyte Autogard is the trade name for the BD catheter with a safety mechanism. Bard makes all other types of catheter but not a short periperhal one.
Also sorry you have had problems especiallly with the materials management side of it. I would advise you to join the product assessment team (whomever makes these decisions). It makes advocating for or against a product much easier and more effective.
We have been using the Nexiva for several years now (think we were a beta site). It did take a longer learning curve. However, once you have mastered it, its hard to figure what was so difficult - except remembering how to disingage the needle. Anyway, we have had great success with the catheter. We still have the insyte autoguard (BD) available but usage has changed from a 50 - 50 usage of each catheter (we used to use safti-imtima) to about 50-80 in favor of the Nexiva. It's used exclusively in our CT and other outpatient departments.
Contrary to your experience, I actually enjoy placing the device. The patients comments have been that the stylet seems sharper and therefore it doesn't hurt as much. There is definitely a learning curve to it but with the proper training, I think anyone could get used to it.
The FDA product recalls were probably from initial design of 2003. BD has then redesigned the product. I am not a paid speaker for BD but I can see where everyone could benefit from this product. We concluded a 3-week trial with very good results. I would like to see where you got the product recall information from and ask my BD rep about it. Thanks.
Angelo M. Aguila, MSN, RN, VA-BC
Vascular Access Nurse
[email protected]
We had the EXACT same experience concerning the Nexiva catheters ! It has to make you wonder what type of sales hype is being given that these catheters are railroaded in, even after feedback states that the learning curve is long and we find them not to be patient friendly. We, on the IV team were asked to "trial" them for consideration, wrote out the paperwork with our assessment of the catheter and were told by the powers that be to "get used to them, the whole hospital will be going to them next week and all others will be removed." So much for a trial. The decision had been made long before we even knew they were coming. It took us a year to have decent skill & competency using these catheters (the IV team, the rest of the hospital & ancillary dept.'s still can't do them). We were lucky in being able to keep a small supply of our previous IV's (agreed to by product division, not the nursing supervisory staff) for those with difficult veins. My biggest complaint is the discomfort and pain caused to the patient. 90% of my patients complain that they are very painful during insertion-----the rep replied that these catheters are actually sharper than our Bard Insytes----therefore it must be our techniques, and when that improved there would be no problem. Phooie! I find them to be less manuverable, less pliant, duller & more painful. Unless I have a large straight "easy" vein I revert back to my old standby, particually in the elderly or chronicly ill patients . Let me know how your doing? I'm finally getting the hang of it but it's still not my first choice of equipment and i always have Bard Insytes on the cart. We were told not to use them on pediatric patients under the age of ?6yrs--i could be wrong on the age factor, i'd have to recheck that. so we didn't have to many problems with the pediatric population getting multiple sticks. The whole way it was presented, introduced and the forced change without proper investigation or trial----smells political to me & it stinks.
Sorry you had this problem, but you have misstated one thing. Bard does not manufacturer or sell a short peripheral IV catheter. Insyte is the trademane for the short peripheral catheter made by BD, the same manufacturer as the Nexiva. Insyte Autogard is the trade name for the BD catheter with a safety mechanism. Bard makes all other types of catheter but not a short periperhal one.
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Also sorry you have had problems especiallly with the materials management side of it. I would advise you to join the product assessment team (whomever makes these decisions). It makes advocating for or against a product much easier and more effective.
We have been using the Nexiva for several years now (think we were a beta site). It did take a longer learning curve. However, once you have mastered it, its hard to figure what was so difficult - except remembering how to disingage the needle. Anyway, we have had great success with the catheter. We still have the insyte autoguard (BD) available but usage has changed from a 50 - 50 usage of each catheter (we used to use safti-imtima) to about 50-80 in favor of the Nexiva. It's used exclusively in our CT and other outpatient departments.
Regarding pain ... lido everytime.
Good Luck,
Sharon Symons
Venous Access - Scripps Green Hospital