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Published on: July 13, 2019
Using Implementation Science to Improve Short Peripheral Intravenous Catheter Outcomes
Mary Hook1, Aimee Woda, Kelsey Bohr
1Author Affiliations: Advocate Health, Milwaukee, Wisconsin (Hook); Marquette University College of Nursing & Aurora St. Luke's Medical Center, Milwaukee, Wisconsin (Woda); Vivent Health, Kenosha, Wisconsin (Bohr); Aurora St. Luke Medical Center, Milwaukee, Wisconsin (Ford); Marquette University College of Nursing, Milwaukee, Wisconsin (Singh).
Nurses improved short peripheral intravenous catheter (PIVC) care using implementation science. While overall adverse outcome removals were unchanged, some units saw success, highlighting the value of data and new strategies for better patient care.
Area of Science:
- Implementation Science
- Nursing Practice
- Patient Safety
Background:
- Short peripheral intravenous catheters (PIVCs) are essential in acute care but prone to premature failure.
- Evidence-based policies exist, yet research on nurses' application of evidence and process changes to optimize PIVC outcomes is limited.
- Reducing PIVC removals due to adverse events requires effective implementation strategies.
Purpose of the Study:
- To evaluate and enhance short PIVC insertion and care processes using a theory-based implementation science approach.
- To reduce the frequency of short PIVC removals attributed to adverse outcomes in acute care settings.
- To explore the utility of implementation strategies and data accessibility in improving nursing interventions.
Main Methods:
- A mixed-methods study involving 23 inpatient nursing units at a large urban quaternary medical center.
- Each unit identified and implemented one PIVC care intervention aimed at lowering adverse outcome removals over a 3-month period.
- Convergent analysis of multiple data sources was used to assess process and outcome changes postintervention.
Main Results:
- The overall frequency of PIVC removals for adverse outcomes did not change significantly across all units.
- Several nursing units successfully improved their PIVC-related outcomes by employing specific implementation strategies.
- The determinant framework offered a plausible explanation for the observed variations in intervention success.
Conclusions:
- While overall adverse outcome rates remained below published benchmarks, traditional change strategies showed limited success in some units.
- Implementation strategies, coupled with accessible data, provide a novel approach for nursing units to deploy, monitor, and sustain interventions.
- This study underscores the potential of implementation science to guide nurses in optimizing short PIVC care and improving patient outcomes.
