Determine if the pediatric peripheral vascular access algorithm (PPVAA) led to differences in first-attempt and overall peripheral intravenous (PIV) success, staff attempting PIV access per episode and overall attempts and first PIV attempt success by provider” Hartman et al (2018).
Purpose: Determine if the pediatric peripheral vascular access algorithm (PPVAA) led to differences in first-attempt and overall peripheral intravenous (PIV) success, staff attempting PIV access per episode and overall attempts and first PIV attempt success by provider.
Design/Methods: A two-cohort pre-/post-implementation comparative design involved pediatric nurses and patients. The PPVAA included four components: a patient comfort plan, PIV grading score, nurses’ self-assessed IV access capability and nurse decision to stop-the-line. Two sample t-test or Wilcoxon rank sum test and Pearson’s chi-square test were used to evaluate differences between groups and measures.
Results: Healthcare providers (N = 96) attempted 721 PIV insertions (pre-PPVAA, n = 419 and post-PPVAA, n = 302). Of 78 nurse providers, mean (SD) age was 37.4 (11.0) years and 20.0% self-assessed PIV capability as expert. Of children, mean age was 8.3 (7.0) years. Post-PPVAA, first-attempt (p = 0.86) and overall (p = 0.21) success did not change, though fewer staff were needed per episode to initiate PIV; p = 0.017. Overall rate of success after one attempt in the post-PPVAA period compared to pre-PPVAA was reduced (p = 0.002), reflecting greater awareness to stop-the-line. Compared to pre-PPVAA, advanced practice nurses and non-clinician providers were more likely to achieve success on first attempt.
Conclusions: The PPVAA did not increase first-attempt or overall PIV success; however, it decreased overall IV attempts and the number of staff attempting access per episode.
Practice Implications: The multi-component PPVAA provided a guide for nurses during PIV and assisted decision making to stop attempts in difficult cases.
Hartman, J.H., Baker, J., Bena, J.F., Morrison, S.L. and Albert, N.M. (2018) Pediatric Vascular Access Peripheral IV Algorithm Success Rate. Journal of Pediatric Nursing. 39, p.1–6.
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