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Implementation of a paediatric peripheral intravenous catheter care bundle: A quality improvement initiative.
- Source :
- Journal of Paediatrics & Child Health; Oct2019, Vol. 55 Issue 10, p1214-1223, 10p, 1 Illustration, 4 Charts
- Publication Year :
- 2019
-
Abstract
- <bold>Aim: </bold>To improve paediatric peripheral intravenous catheter (PIVC) care through the implementation of care bundles.<bold>Methods: </bold>A pre-post study using mixed methods (clinical audit, staff survey, parent interviews) in 2016 at a tertiary paediatric hospital in Brisbane was conducted to evaluate the effectiveness of a PIVC insertion and maintenance bundle to improve PIVC insertion, promote function and support practice. Participants included children with PIVC, parents and staff inserting and managing PIVCs. A mnemonic care bundle, SUCCESS PIVCS (At insertion: Skills, Understand and prepare, Consent, Clean site, Escalate, Secure, Sign and document. During management: Prompt removal, Inspect hourly, Vein patency, Clean hands and Scrub the hub), was developed and implemented via visual aids, workshops and change champions. During audit, PIVC first-attempt insertion success, PIVC failure, PIVC dwell, escalation to senior clinicians and insertion and management procedures were measured.<bold>Results: </bold>Pre-implementation audit (n = 102) and survey (n = 117) data described high rates of PIVC failure (n = 50; 49%), difficulty obtaining equipment (n = 64; 55%) and pressure to insert (n = 50; 43%). Parent interviews (n = 15) identified lack of communication, fear, appreciation of skilled technicians and technology and care giver roles as key to improving the experience. After implementation first-attempt insertion success (45 vs. 62%; risk ratio 1.37, 95% confidence interval 1.05-1.78), first-attempt escalation to senior clinicians (junior doctor 72 vs. 41%; P = <0.001) and median PIVC dwell (40 vs. 52 h; P = 0.021) improved.<bold>Conclusion: </bold>This multi-level care bundle demonstrated improvements in the insertion and management of PIVCs; however, PIVC failure remained high. [ABSTRACT FROM AUTHOR]
- Subjects :
- CAREGIVERS
CATHETERS
VISUAL aids
CONFIDENCE intervals
HOSPITAL care
Subjects
Details
- Language :
- English
- ISSN :
- 10344810
- Volume :
- 55
- Issue :
- 10
- Database :
- Complementary Index
- Journal :
- Journal of Paediatrics & Child Health
- Publication Type :
- Academic Journal
- Accession number :
- 139211094
- Full Text :
- https://doi.org/10.1111/jpc.14384