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Published on: January 30, 2015
Arterial catheter maintenance in children: a best practice implementation project
Yuxia Yang1, Weijie Shen1, Yuqing Wang1
1Pediatric Intensive Care Unit, Children's Hospital of Fudan University, Shanghai, China.
Insights
Implementing evidence-based practices for arterial catheter management in a pediatric intensive care unit significantly improved compliance and catheter dwell time. Continuous audits are recommended to sustain these improvements in patient care.
Area of Science:
- Healthcare Quality Improvement
- Pediatric Critical Care
- Evidence-Based Practice Implementation
Background:
- Arterial catheters are essential for hemodynamic monitoring in intensive care units.
- Compliance with evidence-based maintenance practices is suboptimal in pediatric intensive care units.
Purpose of the Study:
- To enhance adherence to evidence-based practices for arterial catheter management in critically ill children.
- To improve patient outcomes through optimized catheter care in a Chinese pediatric intensive care unit.
Main Methods:
- Utilized the JBI Evidence Implementation Framework and i-PARIHS framework to guide practice change.
- Developed a tailored arterial catheter management strategy, simulation training, and standardized flush syringes.
- Assessed compliance through field observations, medical record reviews, and staff/patient interviews.
Main Results:
- Compliance with all thirteen audited criteria for arterial catheter management significantly increased post-intervention.
- The average indwelling time for peripheral arterial catheters was extended.
- Baseline and follow-up audits included 220 and 212 catheters, respectively.
Conclusions:
- The JBI Evidence Implementation Framework effectively improved adherence to best practices for arterial catheter care.
- Sustaining evidence-based behaviors requires ongoing audits and reinforcement among medical staff.
Introduction:
Arterial catheters are widely used in intensive care units for continuous hemodynamic monitoring and blood collection. Evidence-based practices for arterial catheter maintenance are not strictly followed by all medical staff in the pediatric intensive care unit.
Objective:
This study aimed to improve compliance with evidence-based practices for arterial catheter management in critically ill children in a Chinese pediatric intensive care unit.
Methods:
The JBI Evidence Implementation Framework was used to translate evidence into practice. The Integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework was used to identify barriers to compliance with best practices. An arterial catheter management strategy for critically ill children was developed based on the identified barriers, along with a simulation training module and a supply of 10-ml prefilled normal saline flush syringe. Field observations, a review of medical records, and interviews with medical staff and patients were used to assess baseline and follow-up audit compliance with best practices.
Results:
Thirteen criteria were audited in the baseline and follow-up audits using 220 and 212 peripheral arterial catheters, respectively. In the follow-up audit, compliance with all criteria increased and the indwelling time of the peripheral arterial catheter was prolonged.
Conclusions:
The JBI Evidence Implementation Framework was used to improve compliance with the best practices. Future audits should be conducted to sustain the evidence-based behavior of all medical staff.
Spanish Abstract:
http://links.lww.com/IJEBH/A642.
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