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

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.
• 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.