Date on Paper
7-2020
Document Type
Doctoral Paper
Degree Name
D.N.P.
Department
Nursing
Committee Chair
Roser, Lynn P.
Committee Member
Abusalem, Said
Abstract
Purpose: Intravenous (IV) infiltration is recognized as the most frequent complication of IV therapy (Thigpen, 2007). Pediatric patients are at an increased risk due to small and weaker blood vessels, immature skin, lack of subdermal fat, and constant movement (Odom & Lowe, 2018). In 2018, the pediatric intensive care unit (PICU) in a Kentucky children’s hospital reported 229 IV infiltrations, that which included over 10% of the PICU population. As a result, a quality improvement (QI) project was developed to identify and correct barriers to compliance, knowledge gaps, and target specific behaviors that may contribute to IV infiltration in the unit. Methodology: Evidence from the literature and the Institute for Healthcare Improvement (IHI)’s Plan- Do- Study- Act (PDSA) model were utilized to develop a QI project aimed at establishing a baseline in order to improve the unit’s peripheral IV infiltration rate and compliance with policy. Interventions included administration of a pre-test to nursing staff, an educational presentation, a post-test, and four weeks of audits for compliance with the peripheral IV policy. Results: This QI project achieved a 66% decrease in the IV infiltration rate during the four weeks of audits when compared with the infiltration rate for the four months prior to the project’s implementation. A 10.10% increase in test score from pre- to post-test was obtained, as well as a substantial increase in correct responses on many questions. Areas requiring additional nurse education were determined based on the scores and most frequently missed questions. Four weeks of audits allowed for the calculation of a baseline compliance rate with the unit's peripheral IV policy, as well as identified areas that were insufficient in compliance. Conclusion: The first PDSA cycle provided indispensable data for subsequent cycles that will enable the development of increasingly targeted interventions directed at improving the IV infiltration rate and compliance with policy.
Recommended Citation
Jones, Miranda, "Improving peripheral intravenous maintenance compliance to decrease intravenous infiltration in a pediatric ICU." (2020). Doctor of Nursing Practice Papers. Paper 65.
Retrieved from https://ir.library.louisville.edu/dnp/65
