Table 1.
DART3 outcomes. Outcomes, definitions, and data collection organised by RE-AIM domains
| Outcomes | Information | Data source |
|---|---|---|
| Patient and service level outcomes | ||
| Primary | ||
| First attempt insertion success in patients identified as DIVA | One needle puncture, by one inserter, to achieve successful insertion of a functional (can be aspirated/flushed) PIVC 2 | Hospital-based assessments |
| Secondary | ||
| First attempt insertion success for all patients (regardless of DIVA status) | One needle puncture, by one inserter, to achieve successful of a functional (can be aspirated/flushed) PIVC 2 | Hospital-based assessments |
| Number of attempts | Number of skin punctures to attempt PIVC insertion 3 | Hospital-based assessments |
| Procedure outcome: | Successful PIVC insertion; time from PIVC referral to PIVC insertion (censored at 48 h); alternate device; alternate route (e.g., oral) 4 | Hospital-based assessments |
| PIVC failure | Composite measure of local infection, primary bloodstream infection (BSI), occlusion, infiltration/extravasation, dislodgement (includes leaking), thrombosis and/or phlebitis 6 7 | Hospital-based assessments |
| Insertion/post-insertion complications | Bruising, haematoma, nerve injury, arterial puncture, or skin injury as well as the individual components of PIVC failure (above) 6 8 | Hospital-based assessments |
| PIVC dwell time | Time from PIVC insertion to PIVC removal (in hours) 6 | Hospital-based assessments |
| PIVC necessity | PIVC used for fluids or medications within 24 h (excluding patients who require a prophylactic PIVC in situ as part of their treatment e.g., status epilepticus) 5 | Hospital-based assessments |
| Incidence of blood stream infection | Cluster level routinely-collected rates of primary BSI and S. Aureus BSI 9 | Hospital-based assessments |
| Economic outcomes | ||
| Cost-effectiveness | Direct and indirect healthcare costs to the health system, patients/carers: (time to insertion/therapy, cost of products, number of staff, staff time, costs of responding to failed insertion including cancelled appointments) | Hospital-based assessments |
| Implementation outcome- reach | ||
| Number of healthcare professionals attending Ultrasound training | Counts of clinicians attending ultrasound training | Hospital-based assessments |
| Number of staff accredited in ultrasound insertion | Per local ultrasound accreditation requirements | Hospital-based assessments |
| Implementation outcome—adoption | ||
| Healthcare provider engagement | Proportion of patients assessed using the DIVA vein assessment tool | Hospital-based assessments |
| Ultrasound adoption | proportion of DIVA patients with ultrasound used at the first, or any attempt | Hospital-based assessments |
| Patient/carer/parent satisfaction and pain with insertion procedure | 0–10 numeric rating scale 6 | Hospital-based assessments |
| Inserter (initial and/or successful inserter) satisfaction with escalation pathway | 0–10 numeric rating scale 6 | Hospital-based assessments |
| Attitude of healthcare providers with DIVA tools | Degree of acceptability of the DIVA tools by clinicians | Key stakeholder interviews |
| Implementation outcome - implementation | ||
| Fidelity | Degree that the DIVA tools are implemented as planned in original protocol | Key stakeholder interviews |
| Feasibility | Extent that the DIVA tools can be carried out in specific settings | Key stakeholder interviews |
| Outer context | Macro-level external factors including social, funding, and leadership | Key stakeholder interviews |
| Inner context | Micro-level internal factors including behaviours, feedback. | Key stakeholder interviews |
| Implementation outcome—maintenance | ||
| Sustainability of the intervention and effectiveness | First time insertion success at 3- or 6-month sustainability assessments | Hospital-based assessments |
| Satisfactory of stakeholders | 0–10 numeric rating scale 6 | Key stakeholder interviews |
| Financial sustainability | Explored in the cost-effectiveness analysis and qualitatively through interviews with executive stakeholders. | Key stakeholder interviews |
|
Institutionalisation of interventions |
Concerned with sustaining social behavioural change | Key stakeholder interviews |
RE-AIM Reach, effectiveness, adoption, implementation, maintenance