Quality improvement project to reduce infiltration and extravasation events in a pediatric hospital

Area of Science:

• Patient Safety
• Nursing Practice
• Healthcare Quality Improvement

Background:

• Peripheral intravenous (PIV) catheters are crucial for medication delivery but can cause infiltration and extravasation injuries.
• These injuries pose risks to patients, including pain, tissue damage, and prolonged hospital stays.
• Effective PIV site assessment is vital for preventing such adverse events.

Purpose of the Study:

• To develop and implement strategies aimed at reducing PIV infiltration and extravasation injuries.
• To evaluate the effectiveness of a structured PIV site assessment method and staff education on injury rates.
• To assess the sustainability of implemented interventions in a clinical setting.

Main Methods:

• Development of the "touch-look-compare" method for hourly PIV site assessment.
• Implementation of mandatory staff education and competency demonstration for PIV site assessment.
• Performance monitoring and feedback on compliance with hourly PIV assessments.

Main Results:

• A significant reduction in PIV injury rates was observed immediately after intervention implementation.
• The reduction in injuries correlated with improved compliance in performing hourly PIV site assessments.
• The positive impact on injury rates was not sustained over time.

Conclusions:

• Initial interventions showed promise in reducing PIV injuries, highlighting the importance of consistent assessment.
• The lack of sustained improvement suggests a need for ongoing evaluation and refinement of strategies.
• The team is exploring alternative approaches to further decrease PIV infiltration and extravasation injuries.