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Pediatric peripheral intravenous access: does nursing experience and competence really make a difference?

Pamela Larsen¹, David Eldridge, Jason Brinkley

¹Department of Pediatrics, Brody School of Medicine at East Carolina University, 3 E 139 Brody, Greenville, NC 27834, USA. larsenp@ecu.edu

Journal of Infusion Nursing : the Official Publication of the Infusion Nurses Society

|July 16, 2010

Summary

Placing intravenous (IV) lines in children is challenging. While nurse experience matters, factors like predicted difficulty and child cooperation better predict successful IV placement in hospitalized pediatric patients.

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Area of Science:

Pediatric Nursing
Vascular Access Procedures
Clinical Observation Studies

Background:

Peripheral intravenous (IV) catheter placement in pediatric patients presents significant challenges, impacting patient care and requiring skilled practitioners.
Establishing successful IV access is crucial for administering medications and fluids to hospitalized children.

Purpose of the Study:

To investigate the relationship between nurse experience, competence, and the success rate of peripheral pediatric IV placement.
To identify key predictors influencing the time and number of attempts for successful IV insertion in children.

Main Methods:

A prospective, observational study conducted across two institutions.
Real-time, independent observations were used to collect data on 592 pediatric patients and 1135 venipuncture attempts.
Nurse experience and self-rated competence were assessed alongside objective measures of IV placement success.

Main Results:

Successful IV placement averaged 2 venipunctures and took approximately 28 minutes.
Nurse experience and self-rated competence showed a correlation with successful IV placement.
Predicted difficulty of venipuncture, time of day, and child's cooperativeness were stronger predictors of success than nurse experience alone.

Conclusions:

While nurse experience is a factor, other variables significantly influence pediatric IV placement success.
Clinical prediction of difficulty and patient factors are critical for optimizing IV insertion in pediatric populations.
Further research could explore interventions targeting these key predictors to improve first-attempt success rates.