An evidence-based practice project to improve securement and visualization of peripheral intravenous catheters in pediatric patients

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  • Andrea Smith, PhD, RN, CPNP; Jill Isaacson RN, BSN; Leigh Anne Campbell BSN, CPN; Robert Elkin Hill JD, RN, BSN; Shirley D. Martin RN, BSN, CPN; Valerie J. Badgett RN, BSN; Suzanne M. Frey RN, BSN; Melodie Davis MSN, RN; Terri Pearcy RN, BSN, CPN; Mollie D. Kuchta RN, BSN

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http://hdl.handle.net/10755/202159
Abstract

Problem: Securement and visualization of peripheral intravenous catheter sites (PIV) is a common problem for pediatric nurses worldwide because infiltration of IV fluid can lead to serious complications. Quality data, staff nurse, and nursing administration concerns about lack of visualization of PIV sites led to the need to identify best evidence for securing PIVs so they could be easily assessed. An evidence-based practice (EBP) team representing a wide variety of units was assembled to conduct the project. EBP Model: The IOWA Model of EBP was used to guide the project.

Method: The team conducted a comprehensive search of on-line databases locating over 30 research and non-research articles. Following critique and synthesis, the team identified key EBP: 1) use of clear dressings & tape, 2) use of catheter stabilization devices, 3) use of IV protectors, 4) labeling of dressings, & 5) hourly rounding to assess PIVs. A baseline audit of 90 PIVs on varying units identified the following current practice: 40% of the PIV sites were not visible, clear dressings were only used 40% of time, IV protectors were used in 11.7% of the PIVs, no catheter stabilization devices were used, and mean duration of PIV was 38.2 hrs. A pilot to test the evidence change in practice was implemented on 65 PIVs on 2 medical surgical units using an IV start kit manufactured to contain the EBP materials.

Outcomes: Following successful pilot testing and staff education, the new EBP bundle was initiated house wide. Outcomes 6 months post implementation indicated strong improvement in practice -- 95% of sites were clearly or easily visible, IV protectors used in 81% of IVs, clear dressings used 92%, catheter stabilization devices used 74%, and mean duration of IV increased to 62.9 hrs. IV infiltration data indicated decreasing severity with earlier recognition and removal of IVs.

Description

41st Biennial Convention: People and Knowledge: Connecting for Global Health

Repository Posting Date
2012-01-11T11:13:11Z
Notes

Items submitted to a conference/event were evaluated/peer-reviewed at the time of abstract submission to the event. No other peer-review was provided prior to submission to the Henderson Repository, unless otherwise noted.

Type Information
TypePresentation
AcquisitionProxy-submission
Review TypeAbstract Review Only: Reviewed by Event Host
FormatText-based Document
Category Information
Evidence LevelN/A
Research ApproachN/A
KeywordsEBP;
intravenous lines;
pediatric
Conference Information
Name41st Biennial Convention: People and Knowledge: Connecting for Global Health
HostSigma Theta Tau International
LocationGrapevine, Texas, USA
Date2011
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