Can a Simple “NIR Huddle” Improve Neonatal IV Success? What This Study Found
Study Overview
Peripheral IV catheter (PIVC) insertion in neonates can be difficult, often requiring multiple attempts that cause stress for babies, families, and clinicians. This pre-post implementation study tested a practical workflow change: a brief near-infrared (NIR) “huddle” before cannulation. During the huddle, staff used NIR vein visualisation to plan the best insertion site(s), align on an approach, and set expectations before the attempt.
The project ran across three phases: baseline, education, and implementation. Over five months, the team captured data from 248 neonates, with 370 cannulation events included for analysis.
Key Findings
- First-attempt success did not improve
First-attempt success rates did not show a meaningful improvement after education or implementation of the NIR huddle approach.
- The huddle was more valued than the device
Clinicians rated the huddle process as more acceptable than the NIR device itself—suggesting the structured team pause may have felt more useful than the technology component.
- Insertion site choice mattered
Forearm attempts were associated with higher first-attempt failure compared with hand/wrist sites, reinforcing how important site selection is in neonatal cannulation.
- Other improvements were seen
While first-attempt success didn’t shift, the project noted improvements in areas like PIVC dwell time and documentation quality, indicating potential downstream workflow benefits.
Implications
This study highlights an important reality: a planning “huddle” with NIR support may standardise practice, but it doesn’t automatically increase first-stick success in neonates. Still, the approach may be valuable for creating a consistent decision-making moment—especially for agreeing on site choice, escalation triggers, and clear documentation.
The findings also point clinicians toward a practical consideration: hand/wrist may be a better first option than forearm in this context, given the observed differences in failure risk.
Authors: Deanne August; Nicole Marsh; Stephanie Hall; Ruth Royle; Linda Cobbald; Pieter Koorts; Linda McLaughlin; Gillian Lack; Danika Iminof; Katie Foxcroft; Robert S. Ware; Amanda Ullman
