Natural history of peripheral intravenous cannulas in a paediatric population. | ACCYPN

Natural history of peripheral intravenous cannulas in a paediatric population.

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Presenters: Fiona Newall1,2, Adam Rozsa3, Amy Bell3, Ellen Short3, Simone Burton3, Stacey Richards1

Organisation: 1The Royal Childrens Hospital Melbourne, VIC, Australia, 2Murdoch Childrens Research Institute, VIC, Australia, 3University of Melbourne, VIC, Australia

Date of Presentation: 20/10/2014

Abstract:

AIM:
The study investigated the natural history of PIVCs at The Royal Children’s Hospital, Melbourne. Establishing prevalence, clinical characteristics and removal circumstances may identify strategies to improve PIVC management in children.
METHOD:
This prospective observational audit collected predetermined data relating to PIVCs in patients admitted to the RCH across 5 consecutive days. A customised data collection tool was used to record data on each cannula included in the study. Data was obtained from daily observations, patient charts, medication records, fluid balance charts and nursing staff. A 3-day pilot study tested inter-rater reliability of the collection tool, auditor documentation, study protocols and procedures to achieve acceptable consistency (≥80%). Auditors received clinical education on vascular anatomy related to PIVC siting, securement methods and components.
RESULTS:
56 PIVCs were identified at Day 1. The study documented 18 unplanned removals (33%) over the five audit days. Dorsal aspect of the hand was the most prevalent site (62.5%), followed by forearm (16%) and cubital fossa (16%). The 22GA(blue) cannula provided the primary method of cannulation (66%), delivered via the dorsal venous network (60%), with no splinting present (64%).
CONCLUSION:
This describes the natural history of PIVCs in a tertiary paediatric hospital setting not described previously. The key finding suggests a higher-than-expected number of unplanned PIVC removals across the 5 days of observation. Further, this prospective audit has identified areas where further research should be conducted to improve the clinical outcomes related to PIVCs in paediatric populations.

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