Guides, algorithms and other support tools to improve neonatal and pediatric venous access care: A scoping review. J Hosp Med 2026 Sep;21(9):1035-1046
Date
08/03/2026Pubmed ID
42543878Pubmed Central ID
PMC13534897DOI
10.1002/jhm.70407Scopus ID
2-s2.0-105046427626 (requires institutional sign-in at Scopus site)Abstract
BACKGROUND/OBJECTIVE: Despite the ubiquitous need of venous access in children, care is often highly variable, lacking standardization. Our objective was to review current venous access guides, algorithms, and other tools available for clinical implementation; map out their focus (device type, population); and identify quality gaps.
METHODS: A scoping review with a systematic search of Ovid MEDLINE and other databases was completed on January 24, 2025. All study designs describing the development of venous access guides/algorithms/tools for patients aged <18 years in the emergency department or inpatient units published after 2013 in English were included. Descriptive analysis was used to summarize the results. Quality of studies was assessed using the Appraisal of Guidelines for Research Evaluation (AGREE II) tool.
RESULTS: Of the 105 studies included, 18% (n = 19) involved peripheral access, 66% (n = 69) involved central access, and 16% (n = 17) involved both. Neonates were the population of focus in half the publications (n = 52), and reduction in central line-associated bloodstream infections (CLABSI) was the primary aim of 56% (n = 59) of publications. Device selection and removal were two components of care with the lowest representation, particularly for peripheral access. Based on AGREE II scoring, 50% (n = 53) of identified guides/algorithms/tools were recommended for use. The lowest scoring quality domains were rigor of development and applicability, with 25% (n = 26) and 28% (n = 29) of studies, respectively, scoring in the lowest quintile.
CONCLUSIONS: Most venous access guides/algorithms/tools focus on CLABSI reduction and neonates, leaving gaps in guidance for other components of the care process and other populations.
Author List
Burek AG, Butler K, Liljestrom T, Weber E, Endres G, Stutzman L, Porada K, Mohammed A, Severson HE, Flynn KE, Ullman A, Davis MBHAuthors
Alina G. Burek MD Associate Professor in the Pediatrics department at Medical College of WisconsinKathryn Eve Flynn PhD Vice Chair, Professor in the Medicine department at Medical College of Wisconsin
Tracey H. Liljestrom MD Associate Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AlgorithmsCatheter-Related Infections
Catheterization, Central Venous
Catheterization, Peripheral
Child
Humans
Infant
Infant, Newborn
Practice Guidelines as Topic
