Quality Improvement Initiative to Reduce Intravenous Line-related Infiltration and Phlebitis Incidence in Pediatric Emergency Room.
Infiltration
Pediatric emergency
Phlebitis
Quality improvement
Journal
Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine
ISSN: 0972-5229
Titre abrégé: Indian J Crit Care Med
Pays: India
ID NLM: 101208863
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
entrez:
28
6
2021
pubmed:
29
6
2021
medline:
29
6
2021
Statut:
ppublish
Résumé
To reduce the incidence of infiltration and phlebitis by 50% over 2 months among children admitted to the emergency room (ER) of a tertiary care hospital. The study was conducted in the pediatric ER of a tertiary care hospital in North India. All children aged >28 days, receiving intravenous (IV) medication and/or fluids, were enrolled between June (2017) and September (2017). Existing practices of IV line insertion and maintenance were observed and recorded. The visual infusion phlebitis score and infiltration assessment scale were to grade the extent of two. The intervention classified as "IV line insertion and maintenance bundle" included the introduction of low-cost mobile sterile compartment trays, audit and feedback, organizational change, introduction of infection control nurse and quality improvement (QI) team formations were implement in different Plan-Do-Study-Act (PDSA) cycles. Reduction in the "incidence of phlebitis and infiltration" was outcome measures while "scores on checklist of IV line insertion and IV line maintenance and administration of drugs" were process measures. The process measures, for IV line insertion, maintenance and administration of drugs through IV line, revealed an increase in scores on the checklist. There was a significant decrease in the incidence of infiltration and phlebitis from 82.9 and 96.1% to 45 and 55%, respectively, postimplementation of all PDSA cycles. Multifaceted QI IV line insertion and maintenance bundle reduced the incidence of infiltration and phlebitis. These interventions when integrated into daily work bundles along with continuous education and motivation help in sustaining the goal and attaining long-term success. Singh N, Kalyan G, Kaur S, Jayashree M, Ghai S. Quality Improvement Initiative to Reduce Intravenous Line-related Infiltration and Phlebitis Incidence in Pediatric Emergency Room. Indian J Crit Care Med 2021;25(5):557-565.
Identifiants
pubmed: 34177176
doi: 10.5005/jp-journals-10071-23818
pmc: PMC8196366
doi:
Types de publication
Journal Article
Langues
eng
Pagination
557-565Commentaires et corrections
Type : ErratumIn
Informations de copyright
Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.
Déclaration de conflit d'intérêts
Source of support: Nil Conflict of interest: None
Références
Int J Qual Health Care. 2009 Apr;21(2):119-29
pubmed: 19155288
Am J Infect Control. 2003 Dec;31(8):475-80
pubmed: 14647110
Clin Infect Dis. 2015 Jun 1;60(11):1690-9
pubmed: 25676799
Ann Emerg Med. 2014 Sep;64(3):299-313
pubmed: 24721718
Am J Infect Control. 2014 Oct;42(10 Suppl):S274-83
pubmed: 25239722
Cochrane Database Syst Rev. 2017 Sep 01;9:CD005186
pubmed: 28862335
Clin Infect Dis. 2014 Jul 1;59(1):96-105
pubmed: 24723276
Ann Intern Med. 1991 May 15;114(10):845-54
pubmed: 2014945
J Hosp Infect. 2011 Jan;77(1):37-41
pubmed: 21130520
Pediatr Crit Care Med. 2013 Jun;14(5):525-32
pubmed: 23867430
PLoS One. 2016 Jun 28;11(6):e0158045
pubmed: 27351488
Indian J Med Res. 2016 Apr;143(4):502-6
pubmed: 27377508
Hum Resour Health. 2013 Aug 14;11:37
pubmed: 23945073
J Hosp Infect. 2000 Aug;45(4):302-10
pubmed: 10973748
Clin Biochem. 2012 Sep;45(13-14):999-1011
pubmed: 22709932
Int J Emerg Med. 2010 Nov 05;3(4):409-23
pubmed: 21373313
Crit Care Clin. 1998 Apr;14(2):339-46
pubmed: 9561821
Am J Med. 2002 Aug 1;113(2):146-51
pubmed: 12133753
Br J Nurs. 2015 Apr 23-May 13;24(8):S23-4, S26, S28
pubmed: 25904533
Health Serv Res. 2006 Apr;41(2):307-34
pubmed: 16584451
J Infus Nurs. 2001 Sep-Oct;24(5):332-41
pubmed: 11575049
Hu Li Za Zhi. 2015 Jun;62(3 Suppl):49-57
pubmed: 26074117
J Intraven Nurs. 2001 Jan-Feb;24(1):19-24
pubmed: 11836840
Ann Emerg Med. 2008 Aug;52(2):126-36
pubmed: 18433933
Cochrane Database Syst Rev. 2015 Aug 14;(8):CD007798
pubmed: 26272489
J Infus Nurs. 2006 Jan-Feb;29(1 Suppl):S1-92
pubmed: 16429002
Ther Clin Risk Manag. 2014 Dec 08;10:993-1001
pubmed: 25525365
Nurs Times. 2011 Sep 13-19;107(36):12-4
pubmed: 21998936
Adv Neonatal Care. 2013 Jun;13(3):154-63; quiz 164-5
pubmed: 23722485
J Infect Prev. 2018 Jan;19(1):6-15
pubmed: 29317909
Medicina (Kaunas). 2004;40(1):84-91
pubmed: 14764988