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Reducing extravasation and infiltration in the pediatric population: a best practice implementation project.
Brandy Wilson1,2, Linda Upchurch1,2
1School of Nursing, University of Mississippi Medical Center, Jackson, MS, USA.
JBI Evidence Implementation
|March 25, 2026
Summary
Implementing hourly assessments and education significantly reduced intravenous complications in pediatric patients. This evidence-based practice improves patient safety and care quality by preventing infiltrations and extravasations.
Area of Science:
- Nursing Practice
- Patient Safety
- Pediatric Care
Background:
- Peripheral intravenous (PIV) therapy is a common hospital procedure with frequent complications like infiltration and extravasation.
- Evidence-based practices, including the Assess, Compare, Touch (ACT) method and rounding tools, are recommended to mitigate these risks.
- Rising incidences of intravenous complications necessitate improved clinical practices.
Purpose of the Study:
- To decrease infiltration and extravasation complications at PIV catheter sites in pediatric patients.
- To implement and evaluate evidence-based practices for PIV management.
- To improve the quality of care for pediatric patients receiving PIV therapy.
Main Methods:
- Guided by the JBI Evidence Implementation Framework.
- Conducted baseline and follow-up audits to assess adherence to PIV assessment policies.
- Implemented educational strategies on hourly PIV assessment using ACT and a rounding tool.
- Introduced an algorithm for managing extravasations and infiltrations.
Main Results:
- Baseline audit showed only 9.09% hourly PIV assessment adherence using ACT.
- No established protocol for managing extravasation/infiltration at baseline.
- Post-implementation data on practice changes were collected via follow-up audit.
- Nurse surveys indicated a need for enhanced education on managing PIV-related injuries.
Conclusions:
- Continuing education and established protocols are crucial for improving PIV care in pediatric patients.
- Strengthening staff knowledge and skills can effectively prevent PIV infiltrations and extravasations.
- Evidence implementation projects can enhance the quality of care and patient safety.
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