Date of Award

11-4-2020

Document Type

Capstone

Degree Name

Doctor of Nursing Practice (DNP)

School Name

Donna and Allan Lansing School of Nursing and Health Sciences

Department

Nursing

Major Advisor

Sherill Cronin

Abstract

Abstract

It is estimated that over 90% of hospitalized patients require IV access during their hospitalization. Peripheral IVs (PIVs), while less risky than central lines, are not without risk to the patients. Intravenous (IV) infiltration in pediatric patients is a very common complication associated with IV access, accounting for about 67% of IV catheter removals; a less common complication, but much more serious complication of a PIV can be a blood stream infection (BSI) which can account for up to 35% of BSIs seen in patients. BSIs are associated with increased length of stay, increased morbidity and can result in patient death. In addition, BSIs are estimated to cost approximately $30,000 per infection to treat. IV infiltrates result in pain for the patients, another painful procedure and in 11%-25% of severe cases can result in plastic surgery and long-term complications. The goal of this project was to evaluate if a Peripheral IV Bundle can decrease complications associated with PIVs; specifically, efforts were focused on preventing IV infiltrates and BSIs, as well as decreasing the number of IV starts a patient experiences during a hospitalization.

Results: Compliance with the new PIV bundle averaged 51% over the 5 month time frame, however did improve with each month. IV infiltrates rates decreased from the pre-implementation phase to the post-implementation from 19.16/1000 patient days to 15.87/1000 patient days (P=0.556). PIV duration increased from 71 hours pre implementation to 99 hours post implementation.

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