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Extravasation Identification and Management in Neonates and Pediatrics: A Cross Sectional Survey
Linda N Nguyen1, Mari Takashima1,2, Jacqueline Cunninghame1
1School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia.
Insights
Neonatal and pediatric clinicians face challenges identifying and managing extravasation injuries due to inconsistent practices and lack of training. Standardized protocols and education are crucial for improving patient outcomes and reducing healthcare burdens.
Area of Science:
- Pediatric Nursing
- Neonatal Care
- Clinical Practice Guidelines
Background:
- Extravasation injuries are a significant concern in neonatal and pediatric settings.
- Current practices and guidelines for managing these injuries vary widely.
Purpose of the Study:
- To investigate current practices and guidelines for identifying and managing extravasation injuries.
- Focus on Australian and New Zealand neonatal and pediatric clinical settings.
Main Methods:
- A descriptive, cross-sectional survey was conducted online.
- Data collected from neonatal and pediatric clinicians in Australia and New Zealand (February-September 2023).
- Utilized exponential non-discriminative snowball sampling.
Main Results:
- Most respondents (68.1%) were registered nurses, with many having over 20 years of experience (36.2%).
- A significant majority (69.5%) lacked specific training in extravasation identification and management.
- Inconsistent monitoring and management practices were reported, with a lack of formal grading scales for severity.
Conclusions:
- Clinicians encounter difficulties in identifying and managing extravasation injuries.
- There is a clear need for standardized management protocols, effective monitoring, and comprehensive education.
- Addressing these gaps can minimize the impact of extravasation injuries on patients, families, and healthcare systems.
Objective:
To explore current practice and guidelines surrounding the identification and management of extravasation injuries in Australian and New Zealand neonatal and pediatric settings.
Methods:
Between February and September 2023, an internet-based descriptive cross-sectional survey was distributed to Australian and New Zealand neonatal and pediatric clinicians using exponential nondiscriminative snowball sampling. Survey data domains included demographics, extravasation identification, management, local guidelines, and resources.
Results:
Of the 141 responses, the majority of respondents were registered nurses (n = 96, 68.1%), with greater than 20 years of experience (n = 51, 36.2%). Over two-thirds of respondents had no extravasation identification and management training (n = 98, 69.5%). Half of the respondents (n = 70, 49.6%) reported that increased presentation of risk factors did not alter monitoring frequency. Extravasations were primarily associated with the hand and wrist region (n = 118, 43.7%). Maintenance fluids, antibiotics and parenteral nutrition accounted for extravasation events. Acute management practices (immediate cessation of infusion) showed consistency (n = 124, 87.9%), whereas varying degrees of adoption were observed for aspirating the residual fluid. The majority of respondents (n = 119, 84%) reported the absence of a formal grading scale for extravasation severity.
Conclusions:
Clinicians reported challenges and inconsistencies in neonatal and pediatric extravasation injury identification and management. This underscores the need for effective monitoring and identification, standardized management practices, and education to minimize the burdens of extravasation for patients, families, and the health care system.
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