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Published on: June 11, 2012
Improving the Visibility of Intravenous (IV) Site in Pediatric Patients to Reduce IV Site Related Complications - An
Eunice Ya Ping Lim1, Cassandra Yuit Wah Wong1, Lay Kee Kek1
1Khoo Teck Puat-National University Children's Medical Institute, National University Hospital, 1E Kent Ridge Road, Singapore 119228, Singapore.
Insights
Using more adhesive transparent dressings improved IV site visibility and nurse compliance, reducing IV complications like phlebitis and extravasation in pediatric patients. This enhanced monitoring led to cost savings and better patient care.
Area of Science:
- Pediatric Nursing
- Medical Device Innovation
- Patient Safety
Background:
- Poor visibility of intravenous (IV) sites due to inadequate securement dressings hinders proper monitoring.
- This can lead to delayed detection of IV complications such as phlebitis and extravasation.
- Pediatric patients require specialized care to minimize distress during procedures.
Purpose of the Study:
- To enhance IV site visibility using more adhesive transparent dressings.
- To achieve 90% compliance in frequent and proper IV site inspection.
- To decrease the incidence of IV complications in a pediatric ward.
Main Methods:
- Implementation of a more adhesive securement dressing in a 43-bedded pediatric ward.
- Conducted pre-implementation, post-implementation, and sustainment audits.
- Analyzed cost-effectiveness and compared IV complication rates (phlebitis, extravasation) pre- and post-intervention.
Main Results:
- IV site visibility improved from 73% to 100% post-implementation.
- Nurse compliance with IV site inspection increased from 70% to 87%, reaching 100% during sustainment.
- Incidences of phlebitis and extravasation reduced by 13%, with fewer and less severe cases.
Conclusions:
- Adhesive transparent dressings significantly improve IV site visibility and nursing compliance for IV site checks.
- This intervention aids in the prevention and earlier detection of phlebitis and extravasation.
- The study demonstrated cost savings in manpower, allowing reallocation of staff time to other patient care activities.
Purpose:
This project aims to improve the visibility of the IV site using more adhesive transparent dressings to attain 90% compliance based on the frequent and proper inspection of the IV site and decrease the incidence of IV complications.
Design And Method:
The project was conducted in a 43-bedded general pediatric ward from March 2016 to February 2017. To address the poor visibility of the IV site due to bandaging caused by poor adhesive strength of the IV securement dressing, a more adhesive securement dressing was introduced. The study team conducted pre-implementation, immediate post-implementation, and sustainment audits, cost-analysis, and comparison of the number of reported occurrences of phlebitis and extravasation between 2015 and 2017.
Results:
The post-implementation audit showed 100% visibility of the IV site, from 73% pre-implementation, and 87% compliance on frequent IV site inspection, from 70% pre-implementation. Both criteria attained 100% compliance during the sustainment audit. Incidences of extravasation and phlebitis were reduced from eight to seven, an improvement of 13%. These seven cases were also generally less severe compared to those from the previous year.
Conclusion:
This project has greatly improved the visibility of the IV site as well as nurses' compliance in checking the IV site. This is because nurses can monitor the IV site without having to remove any additional bandage over the site and causing unnecessary distress to fretful pediatric patients.
Implications:
The use of an adhesive transparent dressing can lead to prevention and earlier detection of phlebitis and extravasation. Additionally, the new IV securement dressing brought about manpower cost savings enabling staff time directed to other patient care activities.
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