Developing a minimum dataset: A data discovery project to establish a vascular access registry in paediatric critical care

Abstract

Aims & Objectives: Internationally there is a lack of comparative vascular access device (VAD) data to benchmark practice and evaluate quality initiatives in paediatric intensive care (PIC). A VAD registry is needed to address these knowledge and data capture gaps. We aimed to identify VAD outcomes and quality indicators reported in randomised controlled trials (RCTs) and clinical registries, to inform a homogenous, reliable, minimum dataset for a VAD registry. Methods Scoping review framework. A systematic search of RCTs reporting VAD outcomes in neonates and paediatrics was undertaken in the Cochrane library, EMBASE, CINAHL, PubMed, MEDLINE and EBSCO. Grey literature was systematically searched using google scholar for clinical registries which reported VAD outcomes. Results Ninety one RCTs reporting a total of 340 VAD outcome measures were identified. The most commonly reported outcome measures were insertion variables (53 trials [58%]), infectious complications (36 trials [40%]), and mechanical complications (31 trials [34%]). Patient reported outcomes including pain (13 trials [14%]) and satisfaction (3 trials [3%]) were reported infrequently. Reporting of VAD quality indicators from six clinical registries was limited to blood stream infection (BSI). Conclusions Outcomes reported in RCTs involving children and neonates with VADs were highly heterogeneous with sporadic use of standardised outcome measures and substantial multiplicity. With the exception of BSI, limited VAD quality indicators were collected by registries. These findings inform the next phase of registry development, the establishment of an international consensus regarding a VAD minimum dataset which will improve the usability and availability of VAD information relevant to children, PICs and healthcare systems.L6238157522018-09-13 <br />