Monitoring Peripheral Intravenous Catheters Complications in Pediatric Patients in Erbil City/Iraq
Keywords:Quality of Care, Peripheral Intravenous Catheters, Complications
Backgrounds and Objectives: Although most problems of peripheral intravenous catheterization are inconsiderable and easily treated, some are dangerous and require rapid management. This study aimed to explore peripheral intravenous catheter-related complications and the quality of nursing care for dressing sites of peripheral intravenous catheterization among the pediatric population.
Methods: The study was conducted at Raparin Teaching Hospital for Children inpatient units in Erbil City/Iraq, using an observational study design. A purposive sample from 296 hospitalized children with peripheral intravenous catheterization was chosen for this study. The data was collected using a special check list (PIVC-miniQ) developed for checking the signs and symptoms and the quality of care for the catheter insertion site. Furthermore, the obtained data on peripheral intravenous catheterization problems was evaluated for exploring grades of phlebitis using the Phlebitis Scale developed by the Infusion Nursing Society in 2011. The data was processed and analyzed using SPSS using descriptive statistical analysis (frequency, percentage) and inferential statistical tests (Chi-squared, contingency coefficient). The probability value of ≤0.05 was regarded as statistically significant.
Results: Most (82.4%) of patients were recruited in the emergency unit, with the highest percentage (36.8%) were toddlers. More than two-thirds (72.3%) of participants were assessed within the first peripheral catheter insertion. Regarding overall grades of patients’ peripheral intravenous catheterization complications (PIVC), less than a quarter (21.6%) were within the first grade, indicating being at risk for complications, and 6.8% were within the second grade, indicating slight phlebitis. Regarding the nursing care for PIVC site care, 62.5% of participants received fair care, and 22.3% received poor care.
Conclusions: A quarter of observed children were at risk for having phlebitis and less than ten percent had slight phlebitis. About a quarter of patients received poor nursing care for the catheter insertion site. Most participants have not a documentation of the peripheral intravenous
Waitt C, Waitt P, Pirmohamed M. Intrave-nous therapy. Postgraduate Medical Jour-nal. 2004; 80(939): 1–6.
Alexandrou E., Ray-Barruel G., Carr P. J., Frost S., Inwood Sh., Higgins N., Alberto L., and et al , International prevalence of the use of peripheral intravenous catheters Journal of Hospital Medicine. 2015;10(8): 560-3.
Abdelaziz R B, Hafsi H, Hajji H, Boudabous H A, Chehida A B, Mrabet A Kh, and et al, peripheral venous catheter complications in children: predisposing factors in a multi-center prospective cohort study, Bio Medi-cal Centre Pediatrics. 2017; 17:208 DOI 10.1186/s12887-017-0965-y.
Bolcato M, Russo M, Donadello D, Rodri-guez D, Aprile A. Disabling outcomes after peripheral vascular catheter insertion in a newborn patient: a case of medical liabil-ity? The American journal of case reports, 2017; 18:1126-9. DOI: 10.12659/AJCR.904736.
Datta S, Hanning CD. How to insert a pe-ripheral venous cannula. British Journal of Hospital Medicine, 1990; 43(1): 67–9.
Franck L S, Hummel D, Connell K , Quinn D , & Montgomery J.The safety and effi-cacy of peripheral intravenous catheters in ill neonates. Neonatal Network J. 2001; 20(5), 33–38.
Danski MTR, Oliveira GLR, Johann DA, Ped-rolo E, Vayego SA. Incidence of local compli-cations in peripheral venous catheters and associated risk factors. Acta Paul Enferm. 2015; 28(6):517-23. DOI: 10.1590/1982-0194201500087.
Batista OMA, Moreira RF, Sousa AFL, Moura MEB, Andrade D, Madeira MZA. Local com-plications of peripheral intravenous therapy and associated factors Rev Cubana Enferm, 2018; 34(3). Available from: http://www.revenfermeria.sld.cu/index.php/enf/ article/view/1246/374.
Pettit J, Wyckoff M, Peripherally Inserted Central Catheters: Guideline for Practice, National Association of Neonatal Nurses. U.S. Second edition. 2007; ISBN 978-0-9787636-3-3, Available from: www. NANN.org
Hallam C, Weston V, Denton A, Hill S, Boden-ham A, Dunn H, & et al. Development of the UK vessel health and preservation (VHP) framework: A multi-organizational collabo-rative. Journal of Infection Prevention. 2016; 17(2), 65–72. https://doi.org/10.1177/1757177415624752.
Alexandrou E, Ray-Barruel G, Carr P J, Frost S, Inwood, S, Higgins N, and et al. Use of short peripheral intravenous catheters: Characteristics, management, and outcomes worldwide. Journal of Hospital Medicine. 2018; 13(5). available from: https://doi.org/10. 12788/jhm.3039.
Almeida TJC, Miranda JOF, Santos LM, Santa-na RCB, Camargo CL, Nascimento Sobrinho CL. Peripheral venous accesses in hospital-ized children: a photographic study. Journal of Nursing UFPE on line. 2016; 10(2): 701-7.
Costa AB da, Medeiros LNB de, Neves AD, Barbosa MMB, Souza e Silva RGS, Siqueira RM de. Nursing technicians and peripheral venous catheterization in pediatrics. Journal of Nursing UFPE on line. 2020; 14: e244663 DOI: https://doi.org/10.5205/1981-8963.2020.244663.
Indarwati F, Munday J, Keogh S. Nurse knowledge and confidence on peripheral intravenous catheter insertion and mainte-nance in pediatric patients: A multicenter cross-sectional study, Journal of Pediatric Nursing. 2022; 62: 10–16. PMID: 34798582 DOI: 10.1016/j.pedn.2021.11.007
Infusion Nurses Society (INS). Infusion Nursing Standards of Practice, Journal of Infusion Nursing. 2011; 34(1S), 64S-71S, Available from: www.ins1.org.
Kleidon T, JUllman A. Implementation of a pediatric peripheral intravenous catheter care bundle: A quality improvement initia-tive: Success PIVC bundle of care, Journal of Pediatrics and Child Health. 2019; 55(10): 1214-1223. DOI:10.1111/jpc.14384
Høvik L H, Gjeilo k h, Lydersen S, Rickard C M, Røtvold B, Damås J K, and et al. Moni-toring quality of care for peripheral intra-venous catheters; feasibility and reliability of the peripheral intravenous catheters mini questionnaire (PIVC-miniQ), BMC Health Services Research. 2019; 19:636 https://doi.org/10.1186/s12913-019-4497-z
Zempsky WT. Optimizing the management of peripheral venous access pain in chil-dren: evidence, impact, and implementa-tion. Pediatrics. 2008; 122(3): S121–4.
Garland J S , Dunne Jr W, Havens P, Hintermeyer M, Bozzette M A, Wincek J, Bromberger T,& et al. Peripheral intra-venous catheter complications in critically ill children: a prospective study. Pediatrics. 1992; 89 (6 Pt 2): 1145-50. PMID: 1594367.
Karaoğlan N, Hatice Yıldırım Sarı H Y, Devrim I. Complications of peripheral intravenous catheters and risk factors for infiltration and phlebitis in children. British Journal Nursing. 2022; 31(8): S14-S23. doi: 10.12968/bjon.2022.31.8. S14.
Unbeck M, Forberg U, Ygge BM, Ehrenberg A, Petzold M, Johansson E. Peripheral ve-nous catheter related complications are common among paediatric and neonatal patients. Acta Paediatr. 2015; 104 (6): 566–74.
Charan J , Biswas T . How to Calculate Sample Size for Different Study Designs in Medical Research, Indian J. Psychol. Med. 2013; 35(2), 121–126. Available from: https://doi.org/10.4103/0253-7176.116232
Monreal M, Quilez F, Rey‐Joly C, Vega J, Torres T, Valero P, & et al. Infusion phlebitis in patients with acute pneumonia: a pro-spective study. Chest. 1999; 115:1576‐80.
Sharma S K, Mudgal Sh K, Thakur K, Gaur R. How to calculate sample size for observa-tional and experimental nursing research studies? National Journal of Physiology, Pharmacy and Pharmacology. 2020;10(1):1-8
How to Cite
Copyright (c) 2022 Norhan Zeki Shaker (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.