2.50
Hdl Handle:
http://hdl.handle.net/10755/203266
Type:
Presentation
Title:
Improving Securement and Visualization of Pediatric Peripheral Intravenous Catheters
Abstract:
(Summer Institute) Problem: Securement and visualization of peripheral intravenous catheter sites (PIV) is a common problem for pediatric nurses. Infiltration of IV fluid can lead to serious complications. Quality/Risk data, staff nurse, and nursing administration concerns about lack of visualization of PIV sites led to an EBP project to identify best evidence for securing PIVs so they could assessed easily. Evidence: The EBP team conducted a comprehensive search of on-line databases for 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. Strategy: The IOWA Model of EBP (Titler et al, 2001) was used to guide the project. Practice Change: Baseline audit of 90 PIVs identified 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 bundle in practice was implemented on 2 medical surgical units using an IV start kit manufactured to contain the EBP materials. Evaluation: Following successful pilot testing improvement in baseline measures, staff satisfaction (98%) and decreased cost of IV kits ($1.29 less than purchasing items individually), a staff education program and the new EBP bundle were initiated on inpatient units house-wide. Results: Outcomes 6 months post implementation indicated strong improvement in practice – 95% of sites were visible, IV protectors used in 81%, clear dressings used 92%, catheter stabilization devices used 74%, and mean duration of IV increased to 62.9 hrs. Policy changed to incorporate EBP. Recommendations: Incorporate pilot evaluation measures into on-going QI audits to determine long-term success. Lessons Learned: “See Me See My IV” slogan, multiple learning opportunities, and feedback on specific results increased success. Bibliography: Alexander, M., Corrigan, A., Gorski, L., Hankins, J. & Percucca, R. (Eds.) (2010). Infusion Nurses Society Infusion Nursing An Evidence-based Approach (3rd ed), St Louis: Saunders Elsevier Callaghan, S., Copnell, B., & Johnson, L. (2002). Comparison of two methods of peripheral intravenous cannula securement in the pediatric setting. Journal of Infusion Nursing, 25(4), 256-264 Campbell, H. & Carrington, M. (1999). Peripheral I.V. cannula dressings: advantages and disadvantages. British Journal of Nursing, 8(12), 1420-1422. Gorski, L.A. (2007). Infusion nursing standards of practice. Journal of Infusion Nursing, 30(1) 20-21. Infusion Nurses Society. (2006). Catheter stabilization (43) and Dressings (44). Infusion Nursing , 29(15), 44-45. Jones, A. (2004). Dressings for the management of catheter sites. JAVA, 9(1), 26-33. Madeo, M., Martin, C. & Nobbs, A. (1997). A randomized study comparing IV 3000 to dray gauze for peripheral intravenous sites. Journal of Intravenous Nursing, (20)5, 253-256. McCann, B. (2003). Securing peripheral cannulae: evaluation of a new dressing. Paediatric Nursing, 15(5), 23-26. Mosby Nursing Skills (2006). Peripheral intravenous catheter: dressing change (pediatric). Retrieved 24, April, 2009 from Work Wide Web: http://app32.webinservice.com/MosbySkills/skillsMain.asp. Oncology Nursing Society (ONS) (2004). Access device guidelines: recommendation for nursing practice and education (2nd ed). Pittsburg: Oncology Nursing Society. Pettit, J. (2003). Assessment of the infant with a peripheral intravenous device. , 3(5), 230-240. Rosenthal, K. (2005). Tech update: Get a hold on costs and safety with securement devices. Nursing management 36(5), 52-54. Schatzlein, K. (2003). Hold tight: Keeping catheters secure. Nursing 2003. 33(3), 20-22. Schears, G. J. (2006). Summary of product trails for 10,164 patients: comparing an intravenous stabilizing device to tape. Journal of Infusion Nursing, 29(4), 225-231 Smith B. (2006). Peripheral intravenous catheter dwell times: a comparison of 3 securement methods for implementation of a 96-hour scheduled change protocol. Journal of Infusion Nursing, 29(1), 14-17 Smith, B. & Royer, T. I. (2007). New standards for improving peripheral I.V. catheter securement. Nursing, 37(3), 72-74. Titler, M. et al (2001). The Iowa Model of Evidence-Based Practice for Quality Care, Critical Care Clinics of North America (13(3), 497-509. Tripepi-Bova, K., Woods, K., & Loach, M. (1997). A comparison of transparent polyurethane and dry gauze dressings for peripheral IV catheter sites: rates of phlebitis, infiltration, and dislodgement by patients. American Journal of Critical Care, 6(5), 377-381. Vallino, L. (1998). Pediatric nurses contribute to the refinement of an I.V. protector. Journal of Pediatric Nursing, 13(3), 196-198. Woods, D. (1997). A comparative study of two securement techniques for short peripheral intravenous catheters. Journal of Intravenous Nursing, 20(6), 280-285. [© Academic Center for Evidence-Based Practice, 2011. http://www.acestar.uthscsa.edu]
Keywords:
Pediatric; Catheters
Repository Posting Date:
16-Jan-2012
Date of Publication:
3-Jan-2012
Sponsors:
UTHSCSA Summer Institute

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleImproving Securement and Visualization of Pediatric Peripheral Intravenous Cathetersen_GB
dc.identifier.urihttp://hdl.handle.net/10755/203266-
dc.description.abstract(Summer Institute) Problem: Securement and visualization of peripheral intravenous catheter sites (PIV) is a common problem for pediatric nurses. Infiltration of IV fluid can lead to serious complications. Quality/Risk data, staff nurse, and nursing administration concerns about lack of visualization of PIV sites led to an EBP project to identify best evidence for securing PIVs so they could assessed easily. Evidence: The EBP team conducted a comprehensive search of on-line databases for 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. Strategy: The IOWA Model of EBP (Titler et al, 2001) was used to guide the project. Practice Change: Baseline audit of 90 PIVs identified 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 bundle in practice was implemented on 2 medical surgical units using an IV start kit manufactured to contain the EBP materials. Evaluation: Following successful pilot testing improvement in baseline measures, staff satisfaction (98%) and decreased cost of IV kits ($1.29 less than purchasing items individually), a staff education program and the new EBP bundle were initiated on inpatient units house-wide. Results: Outcomes 6 months post implementation indicated strong improvement in practice – 95% of sites were visible, IV protectors used in 81%, clear dressings used 92%, catheter stabilization devices used 74%, and mean duration of IV increased to 62.9 hrs. Policy changed to incorporate EBP. Recommendations: Incorporate pilot evaluation measures into on-going QI audits to determine long-term success. Lessons Learned: “See Me See My IV” slogan, multiple learning opportunities, and feedback on specific results increased success. Bibliography: Alexander, M., Corrigan, A., Gorski, L., Hankins, J. & Percucca, R. (Eds.) (2010). Infusion Nurses Society Infusion Nursing An Evidence-based Approach (3rd ed), St Louis: Saunders Elsevier Callaghan, S., Copnell, B., & Johnson, L. (2002). Comparison of two methods of peripheral intravenous cannula securement in the pediatric setting. Journal of Infusion Nursing, 25(4), 256-264 Campbell, H. & Carrington, M. (1999). Peripheral I.V. cannula dressings: advantages and disadvantages. British Journal of Nursing, 8(12), 1420-1422. Gorski, L.A. (2007). Infusion nursing standards of practice. Journal of Infusion Nursing, 30(1) 20-21. Infusion Nurses Society. (2006). Catheter stabilization (43) and Dressings (44). Infusion Nursing , 29(15), 44-45. Jones, A. (2004). Dressings for the management of catheter sites. JAVA, 9(1), 26-33. Madeo, M., Martin, C. & Nobbs, A. (1997). A randomized study comparing IV 3000 to dray gauze for peripheral intravenous sites. Journal of Intravenous Nursing, (20)5, 253-256. McCann, B. (2003). Securing peripheral cannulae: evaluation of a new dressing. Paediatric Nursing, 15(5), 23-26. Mosby Nursing Skills (2006). Peripheral intravenous catheter: dressing change (pediatric). Retrieved 24, April, 2009 from Work Wide Web: http://app32.webinservice.com/MosbySkills/skillsMain.asp. Oncology Nursing Society (ONS) (2004). Access device guidelines: recommendation for nursing practice and education (2nd ed). Pittsburg: Oncology Nursing Society. Pettit, J. (2003). Assessment of the infant with a peripheral intravenous device. , 3(5), 230-240. Rosenthal, K. (2005). Tech update: Get a hold on costs and safety with securement devices. Nursing management 36(5), 52-54. Schatzlein, K. (2003). Hold tight: Keeping catheters secure. Nursing 2003. 33(3), 20-22. Schears, G. J. (2006). Summary of product trails for 10,164 patients: comparing an intravenous stabilizing device to tape. Journal of Infusion Nursing, 29(4), 225-231 Smith B. (2006). Peripheral intravenous catheter dwell times: a comparison of 3 securement methods for implementation of a 96-hour scheduled change protocol. Journal of Infusion Nursing, 29(1), 14-17 Smith, B. & Royer, T. I. (2007). New standards for improving peripheral I.V. catheter securement. Nursing, 37(3), 72-74. Titler, M. et al (2001). The Iowa Model of Evidence-Based Practice for Quality Care, Critical Care Clinics of North America (13(3), 497-509. Tripepi-Bova, K., Woods, K., & Loach, M. (1997). A comparison of transparent polyurethane and dry gauze dressings for peripheral IV catheter sites: rates of phlebitis, infiltration, and dislodgement by patients. American Journal of Critical Care, 6(5), 377-381. Vallino, L. (1998). Pediatric nurses contribute to the refinement of an I.V. protector. Journal of Pediatric Nursing, 13(3), 196-198. Woods, D. (1997). A comparative study of two securement techniques for short peripheral intravenous catheters. Journal of Intravenous Nursing, 20(6), 280-285. [© Academic Center for Evidence-Based Practice, 2011. http://www.acestar.uthscsa.edu]en_GB
dc.subjectPediatricen_GB
dc.subjectCathetersen_GB
dc.date.available2012-01-16T11:06:46Z-
dc.date.issued2012-01-03en_GB
dc.date.accessioned2012-01-16T11:06:46Z-
dc.description.sponsorshipUTHSCSA Summer Instituteen_GB
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