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Parental holding and positioning to decrease IV distress in young children: a randomized controlled trial.

Laurie A Sparks1, Jennifer Setlik, Janet Luhman

  • 1Barnes-Jewish College of Nursing and Allied Health, St. Louis, MO 63110, USA. las0880@bjc.org

Journal of Pediatric Nursing
|November 27, 2007
PubMed
Summary

Holding young children upright for intravenous (IV) starts significantly reduces distress compared to the traditional supine position. This parent-supported method improves satisfaction without affecting IV success rates, offering a less fearful experience for pediatric patients.

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Area of Science:

  • Pediatric Nursing
  • Child Psychology
  • Medical Procedures

Background:

  • Conventional methods for intravenous (IV) access in young children involve supine restraint, often inducing significant fear and distress.
  • The necessity of supine positioning for pediatric IV procedures has been a long-standing assumption in clinical practice.
  • Minimizing procedural distress is crucial for positive healthcare experiences in pediatric patients.

Purpose of the Study:

  • To evaluate the impact of upright positioning versus supine positioning on distress levels during IV starts in young children.
  • To assess parental satisfaction with different positioning methods for pediatric IV procedures.
  • To determine if positioning affects the number of IV attempts required.

Main Methods:

  • A randomized study involving 118 children aged 9 months to 4 years undergoing IV procedures.

Related Experiment Videos

  • Participants were assigned to either an upright position supported by a parent or a traditional supine position on an exam table.
  • Distress was measured using the Procedure Behavior Rating Scale, and parental satisfaction was recorded.

    • Main Results:

    • The upright positioning group exhibited significantly lower distress scores (p = .000) compared to the supine group.
    • Parents reported higher satisfaction levels when their children were in the upright position.
    • There was no significant difference in the number of IV attempts needed between the two positioning groups.

    Conclusions:

    • Upright positioning, supported by a parent, is an effective strategy for reducing distress in young children during IV procedures.
    • This method enhances parental satisfaction without compromising procedural efficiency.
    • The findings suggest a shift from supine restraint towards upright positioning for pediatric IV starts.