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Inpatients aged 0 to \u2264\u200918\u2009years requiring a peripheral intravenous catheter or who had one inserted in the last 24\u2009h, were eligible. Proportionate stratified random sampling was used. Generalised linear regression with modified Poisson regression assessed associations between patient variables (e.g., age) and first\u2010time insertion success, along with technique (e.g., inserting clinician) and technology (e.g., ultrasound) variables. Models were adjusted for confounding variables identified through direct acyclic graphs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>199 children required 250 peripheral intravenous catheters (July 2022\u2013September 2023). In the adjusted model, each year of age increase and every 5\u2010kg increase in weight were associated with higher first\u2010time insertion success. Children with a history of prematurity had an increased risk of first\u2010time insertion failure. Vascular access specialists were more likely to succeed on the first attempt, as was ultrasound\u2010guidance when adjusted for difficult intravenous access risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We identified techniques (expert clinicians) and technologies (ultrasound guidance) that improve first\u2010time insertion success in paediatric patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications<\/jats:title>\n                    <jats:p>A multi\u2010faceted approach combining technique (clinician), technology (ultrasound guidance), and standardised policy can improve first\u2010time peripheral intravenous catheter insertion. These strategies minimise patient discomfort, trauma, and emotional distress, enhancing the overall healthcare experience for children and their families.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>This study emphasises the need to standardise healthcare policies and training, incorporating clinician expertise and ultrasound guidance to improve first\u2010time insertion success, particularly for high\u2010risk patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Reporting Method<\/jats:title>\n                    <jats:p>The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>No Patient or Public Contribution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      Australia New Zealand Clinical Trials Registry,\n                      <jats:styled-content style=\"fixed-case\">ACTRN12622000034730<\/jats:styled-content>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jan.16795","type":"journal-article","created":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T05:59:46Z","timestamp":1738907986000},"page":"6486-6503","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["A Prospective Cohort Study of Technique and Technology Used to Improve First Time\n                    <scp>PIVC<\/scp>\n                    Insertion Success in Hospitalised Paediatric Patients"],"prefix":"10.1111","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8369-3970","authenticated-orcid":false,"given":"Tricia M.","family":"Kleidon","sequence":"first","affiliation":[{"name":"Vascular Assessment and Management Service (VAMS), Department of Anaesthesia and Pain, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service  Brisbane Queensland Australia"},{"name":"Alliance for Vascular Access Teaching and Research, Schools of Nursing and Midwifery, and Pharmacy and Medical Sciences, Griffith University  Brisbane Queensland Australia"},{"name":"School of Nursing, Midwifery, and Social Work, University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1167-9106","authenticated-orcid":false,"given":"Mari","family":"Takashima","sequence":"additional","affiliation":[{"name":"School of Nursing, Midwifery, and Social Work, University of Queensland  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire M.","family":"Rickard","sequence":"additional","affiliation":[{"name":"Alliance for Vascular Access Teaching and Research, Schools of Nursing and Midwifery, and Pharmacy and Medical Sciences, Griffith University  Brisbane Queensland Australia"},{"name":"School of Nursing, Midwifery, and Social Work, University of Queensland  Brisbane Queensland Australia"},{"name":"Herston Infectious Diseases Institute (HeIDI), Metro North Health, Queensland Health  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica A.","family":"Schults","sequence":"additional","affiliation":[{"name":"Alliance for Vascular Access Teaching and Research, Schools of Nursing and Midwifery, and Pharmacy and Medical Sciences, Griffith University  Brisbane Queensland Australia"},{"name":"School of Nursing, Midwifery, and Social Work, University of Queensland  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