This paper will review and critique Hess's quantitative study of vascular access improvement in pediatric population by using a vein viewing device. The author utilized a prospective, non-randomized study at a tertiary care center. The sample of the study included 150 procedures in the control group and 91 procedures in the experimental group from the ages 0 to 17 years. The primary aim of the study was to increase the first-attempt success rate of venipuncture and decrease procedure time for the study population.
Problem and Purpose
The author of this study reveals the widespread problem of the venipuncture among the pediatric population and clearly states the purpose of the study. Hess (2010) associated the failure of the vascular access with some anatomical, physical, physiological and clinician-related factors. The research purpose of this quantitative study was to evaluate the use of a biomedical device-Vein Viewer in increasing success rate of venipuncture performed by staff nurses (Hess, 2010). The author states three measurements: "1)percent of the first-attempt success, 2) number of attempts per patient, and 3) time needed to complete the procedure." The study purpose flows logically from the problem, which points out the common failure of the first venipuncture attempt (Hess, 2010). Review of Literature
Hess adequately expounds the review of literature, using appropriate scientific studies and clearly demonstrated the importance of the research question. More than half of the sources of the reference list (total 24) were dated within the last five years. However, ten cited articles were older than thirteen years. Additionally, the Vein Viewer is a relatively new device on the health care market. Therefore, there is lack of substantial research regarding its validation and usefulness. Hess is one of the first investigators to evaluate the biomedical device Vein Viewer in a pediatric population. Conceptual and Theoretical Framework
The research does not present a specific theoretical or conceptual framework. The author only describes the technique of the Vein Viewer which projects an image of the veins onto the patient's skin (Hess, 2010). Taking into consideration this concept, it would be logical that this device would ease the peripheral vascular access and increase the success rate of the first attempt. Consequently, one expects a reduction of the number of repetitive attempts of the venipuncture shortening the procedure time.
The researcher conducted a prospective, non-randomized controlled clinical study. The given study has several weaknesses. First, the study was poorly planned because the control group which underwent the traditional venipuncture was studied from August 2006 through January 2007, while data from the experimental group which was using the Vein Viewer was collected from the different time (April 2007-January 2008). This shows that the time frame of experiments was significantly different: five months in the control group versus ten months in the experimental. Moreover, there is no information if the unit nurses were the same in the control group versus the experimental group because of the time difference. It may be that these unit nurses increased their skills over time. The other major weakness of the study is that the data collection was based on self-reported data without any control. The self-reported data frequently misrepresented due to its subjectivity, therefore, it is related to the validity problems. Sample
The research sample is represented by the patients of a tertiary care pediatric hospital. Study included all patients who required the vascular access. Patients were excluded based on criteria not following the study protocol or if any of the access attempts were not performed by the unit nurse (Hess, 2010).
There were several weak points of the study sample. The researcher does not provide clear information about the...