Authors
College of Nursing, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
Abstract
hospital with patients’ admittance. It becomes challenging when it comes to children and requires
more knowledge and skills. The aim of the current study was to assess the effectiveness of the
reinforcement program on adherence to short peripheral catheter (SPC) care guidelines among
registered nurses.
MATERIALS AND METHODS: A quasi‑experimental study was conducted among 44 registered
nurses by observing 96 SPC care events before and after the reinforcement program in pediatric
wards of a tertiary care hospital in Eastern India. The study was conducted in a tertiary care public
hospital in Eastern India in 2019, and the data collection tool included children’s and nurses’
socio‑demographic data and an observation checklist on intravenous catheterization care. Descriptive
statistics were used to explain the participant characteristics, and McNemar’s test was used to identify
the adherence to SPC care guidelines.
RESULTS: There was a statistically significant improvement in most steps, such as hand washing,
gloving, tray preparation, documentation initiation, maintenance, and removal (P = 0.001). A statistically
significant reduction in the early stage of phlebitis was found from 66.7% in pre‑intervention to 37.5%
in post‑intervention (P = 0.027).
CONCLUSIONS: The majority of nurses adhered to SPC care guidelines after the reinforcement
program. From the study findings, it is recommended that regular reinforcement related to peripheral
catheter care acts as a stimulant to adhere to SPC care guidelines. The nursing administration
should take initiative by conducting in‑service training for the nurses, which motivates them toward
practicing quality nursing care.
Keywords
et al. A novel integrated dressing to secure peripheral intravenous
catheters in an adult acute hospital: A pilot randomised controlled
trial. Trials 2018;19:1.
2. Malyon L, Ullman A, Phillips N, Young J, Kleidon T, Murfield J,
et al. Peripheral intravenous catheter duration and failure in
paediatric acute care: A prospective cohort study. Emerg Med
Australas2014;26:602‑8.
3. Tofani B, Rineair S, Gosdin C, Pilcher P, McGee S, Varadarajan K,
et al. Quality Improvement Project to Reduce Infiltration and
Extravasation Events in a Pediatric Hospital. J PediatrNurs
2012;27:682‑9.
4. Rickard CM, Marsh NM. Annals for hospitalists inpatient
notes‑the other catheter—the mighty peripheral IV. Ann Intern
Med 2017;167:HO2‑3.
5. Berragan L. Learning nursing through simulation: A case study
approach towards an expansive model of learning. Nurse Educ
Today 2014;34:1143‑8.
6. Sheahan L, While A, Bloomfield J. An exploratory trial exploring
the use of a multiple intelligences teaching approach (MITA)
for teaching clinical skills to first year undergraduate nursing
students. Nurse Educ Today 2015;35:1148‑54.
7. Zamanzadeh V, Jasemi M, Valizadeh L, Keogh B, Taleghani F.
Lack of preparation: Iranian Nurses’experiences during transition
from college to clinical practice. J Prof Nurs 2015;31:365‑73.
8. Alexandrou E, Ramjan L, Murphy J, Hunt L, Betihavas V, Frost S.
Training of undergraduate clinicians in vascular access: An
integrative review. J AssocVasc Access 2012;17:146‑58.
9. ZinggW, PittetD. Peripheral venous catheters: An under‑evaluated
problem. Int J Antimicrob Agents 2009;34:S38‑42.
10. Ravik M, Havnes A, Bjørk I. Exploring nursing students’ transfer
of peripheral venous cannulation from skills centre to the clinical
setting. JNursEducPract 2014;5.doi: 10.5430/jnep.v5n3p59
11. Whalen M, Maliszewski B, Baptiste D. Establishing a dedicated
difficult vascular access team in the emergency department.
J InfusNurs 2017;40:149‑54.
12. Sou V, McManus C, Mifflin N, Frost S, Ale J, Alexandrou E.
A clinical pathway for the management of difficult venous access.
BMC Nurs 2017;16:64.
13. Benkhadra M, Collignon M, Fournel I, Oeuvrard C, Rollin P,
Perrin M, et al. Ultrasound guidance allows faster peripheral
IV cannulation in children under 3 years of age with difficult
venous access: A prospective randomized study. PediatrAnesth
2012;22:449‑54.
14. Alexander M. Infusion nurses: We’re worth it. J InfusNurs
2013;36:153‑4.
15. Boyd S, Aggarwal I, Davey P, Logan M, Nathwani D. Peripheral
intravenous catheters: The road to quality improvement and safer
patient care. J Hosp Infect 2011;77:37‑41.
16. WebsterJ, Osborne S, Rickard CM, Marsh N. Clinically‐indicated
replacement versus routine replacement of peripheral venous
catheters. Cochrane Database Syst Rev 2019;1:CD007798.
17. Neopane A. Peripheral venous thrombophlebitis risk and the role
of hand washing. Nepal J Med Sci 2013;2:26‑9.
18. Keogh S, Marsh N, Higgins N, Davies K, Rickard C. A time and
motion study of peripheral venous catheter flushing practice
using manually prepared and prefilled flush syringes. JInfusNurs
2014;37:96‑101.
19. Pittet D, Allegranzi B, Boyce J. The world health organization
guidelines on hand hygiene in health care and their consensus
recommendations. Infect Control HospEpidemiol 2009;30:611‑22.
20. Hirschmann H, Fux L, Podusel J, Schindler K, Kundi M, Rotter M,
with assistance of EURIDIKI GW. The influence of hand hygiene
prior to insertion of peripheral venous catheters on the frequency
of complications. J Hosp Infect 2001;49:199‑203.
21. Sabri A, Szalas J, Holmes KS, Labib L, Mussivand T. Failed
attempts and improvement strategies in peripheral intravenous
catheterization. Biomed Mater Eng 2013;23:93‑108.
22. Van Der Woude OC, Cuper NJ, Getrouw C, Kalkman CJ,
Graaff JC. The effectiveness of a near‑infrared vascular imaging
device to support intravenous cannulation in children with dark
skin color. AnesthAnalg 2013;116:1266‑71.
23. Peterson KA, Phillips AL, Truemper E, Agrawal S. Does
the use of an assistive device by nurses impact peripheral
intravenous catheter insertion success in children?. J PediatrNurs
2012;27:134‑43.
24. Moadad N, Kozman K, Shahine R, Ohanian S, Badr LK.
Distraction using the buzzy for children during an IV insertion.
J PediatrNurs2016;31:64‑72.
25. Jacobson AF, Winslow EH. Variables influencing intravenous
catheter insertion difficulty and failure: An analysis of 339
intravenous catheter insertions. Heart Lung 2005;34:345‑59.
26. Yen K, Riegert A, Gorelick MH. Derivation of the DIVA Score:
A clinical prediction rule for the identification of children with
difficult intravenous access. PediatrEmerg Care 2008;24:143‑7.
27. Lapostolle F, Catineau J, Garrigue B, Monmarteau V,
Houssaye T, Vecci I, et al. Prospective evaluation of peripheral
venous Access difficulty in emergency care. Intensive Care Med
2007;33:1452‑7.
28. Simhi E, Kachko L, Bruckheimer E, Katz J. A vein entry indication
device for facilitating peripheral intravenous cannulation
in children: A prospective, randomized, controlled Trial.
AnesthAnalg 2008;107:1531‑5.
29. Nikolaus AH. Clinical review: Vascular access for fluid infusion
in children. Crit Care 2004;8:478‑84.
30. Roberge RJ. Venodilatation techniques to enhance venepuncture
and intravenous cannulation. J Emerg Med 2004;27:69‑73.
31. Ahlqvist M, Berglund B, Wirén M, Klang B, Johansson E. Accuracy
in documentation–a study of peripheral venous catheters.
JClinNurs 2009;18:1945‑52.
32. Yagnik L, Graves A, Thong K. Plastic in patient study: Prospective
audit of adherence to peripheral intravenous cannula monitoring
and documentation guidelines, with the aim of reducing future
rates of intravenous cannula‑related complications. Am JInfect
Control 2017;45:34‑8.
33. Carlet J, Astagneau P, Brun‑Buisson C, Coignard B, Salomon V,
Tran B.et al. French national program for prevention of
healthcare‑associated infections and antimicrobial resistance,
1992–2008: Positive trends, but perseverance needed. Infect
Control HospEpidemiol 2009;30:737‑45.
)