Pediatric Vascular Access Peripheral IV Algorithm Success Rate.

Area of Science:

• Pediatric nursing
• Vascular access
• Clinical algorithms

Background:

• Peripheral intravenous (PIV) access is a common procedure in pediatric care.
• Optimizing PIV success rates and procedural efficiency is crucial for patient comfort and resource utilization.
• Standardized algorithms can guide clinical decision-making in complex procedures.

Purpose of the Study:

• To evaluate the impact of the pediatric peripheral vascular access algorithm (PPVAA) on PIV insertion success rates.
• To assess changes in the number of staff involved and overall attempts per PIV insertion episode.
• To determine if provider type influences first-attempt PIV success post-implementation.

Main Methods:

• A pre-/post-implementation comparative study design involving pediatric nurses and patients.
• The PPVAA incorporated patient comfort, PIV grading, self-assessed capability, and a stop-the-line decision component.
• Statistical analyses included t-tests, Wilcoxon rank sum tests, and chi-square tests to compare outcomes.

Main Results:

• No significant difference was observed in first-attempt (p=0.86) or overall PIV success rates post-PPVAA.
• Fewer staff were required per PIV access episode (p=0.017) after PPVAA implementation.
• A decrease in overall success after one attempt was noted (p=0.002), attributed to increased 'stop-the-line' awareness.

Conclusions:

• The PPVAA did not enhance first-attempt or overall PIV success.
• The algorithm effectively reduced the total number of PIV attempts and the number of staff needed per episode.
• The PPVAA served as a valuable guide for nurses, aiding decisions to cease difficult PIV attempts.