Infiltration, Intravenous, Intravenous Catheters, Pediatrics, Phlebitis
Conditions
Keywords
Peripheral Intravenous Catheter, Care Bundle, Infiltration, Phlebitis, Pediatric Emergency, Nurse Education
Brief summary
This quasi-experimental study evaluates the effectiveness of a care bundle in preventing peripheral intravenous catheter (PIVC)-related infiltration and phlebitis in pediatric emergency department patients. The care bundle includes interventions such as nurse education, hand hygiene, aseptic techniques, and the use of antiseptic solutions (2% chlorhexidine and 70% alcohol) for PIVC insertion and maintenance. The study compares the incidence of infiltration and phlebitis between the intervention and control groups.
Detailed description
This study was conducted in the Pediatric Emergency Department of Dr. Sadi Konuk Education and Research Hospital, involving 200 pediatric patients, with 100 in the intervention group and 100 in the control group. The intervention group received a care bundle, which included education on peripheral intravenous catheter management, hand hygiene, aseptic techniques, and the use of antiseptic solutions (2% chlorhexidine and 70% alcohol). The control group received standard care according to routine practice. The incidence of infiltration and phlebitis was compared between the groups, with data collected using the Visual Infusion Phlebitis Assessment Scale (VIPAS) and Pediatric Peripheral Intravenous Infiltration Scale (PPIIS).
Interventions
BEHAVIORALCare Bundle for PIVC Management
The intervention group will receive a care bundle designed to reduce peripheral intravenous catheter (PIVC)-related complications (infiltration and phlebitis). The bundle includes the following components: Nurse Education: Training on PIVC management and best practices. Hand Hygiene: Emphasis on proper hand hygiene before and after each insertion and maintenance procedure. Aseptic Techniques: Strict adherence to aseptic technique during PIVC insertion and maintenance. Antiseptic Solutions: Use of 2% chlorhexidine and 70% alcohol for skin preparation and catheter insertion. Stabilization: Use of hydrocolloid transparent adhesive bandages for catheter fixation to prevent dislodgement and reduce irritation. Insertion Attempts: Limiting the number of attempts to a maximum of two to reduce trauma to the insertion site. Monitoring and Documentation: Regular assessment of the PIVC site for complications and accurate documentation by nursing staff.
Sponsors
Istanbul University - Cerrahpasa
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
28 Days to 18 Years
Healthy volunteers
Yes
Inclusion criteria
Children admitted to the Pediatric Emergency Department First-time peripheral intravenous catheter (PIVC) insertion Ages between 28 days to 18 years At least 6 hours of observation after catheter insertion Fluid administration in the observation area (e.g., 5% dextrose + 0.45% NaCl + 5/10 cc potassium) Written informed consent obtained from parents/legal guardians Children willing to participate in the study
Exclusion criteria
Children with skin problems (e.g., epidermolysis bullosa) Children allergic to products used in the care bundle Children who have undergone procedures that could cause catheter displacement or infiltration (e.g., lumbar puncture) Children with chronic vascular issues (e.g., vasculitis, hematologic disorders, congenital vascular anomalies) Children transferred to intensive care or another department after PIVC insertion Children with clinical conditions that prevent standard care bundle application (e.g., extreme agitation, inability to immobilize extremities)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of Peripheral Intravenous Catheter-Related Infiltration | From the time of catheter insertion to 6 hours post-insertion | The primary outcome is the incidence of PIVC-related infiltration in pediatric patients. Infiltration will be assessed using the Pediatric Peripheral Intravenous Infiltration Scale (PPIIS). |
| Incidence of Peripheral Intravenous Catheter-Related Phlebitis | From the time of catheter insertion to 6 hours post-insertion. | the incidence of PIVC-related phlebitis. Phlebitis will be assessed using the Visual Infusion Phlebitis Assessment Scale (VIPAS). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| First Attempt Success Rate for PIVC Insertion | Procedure (During initial PIVC insertion attempt.) | The percentage of successful PIVC insertions on the first attempt. |
| Number of PIVC Insertions | At the time of PIVC insertion procedure | The total number of PIVC insertion attempts for each patient. Assessment Method: Clinical record review. |
| Nurse Adherence to Care Bundle Protocol | At the time of PIVC insertion procedure | The degree to which nurses adhere to the care bundle protocol (hand hygiene, aseptic techniques, antiseptic use, etc.). Assessment Method: Adherence checklists and observation by researchers |
Countries
Turkey (Türkiye)
Outcome results
None listed