Effectiveness of peripheral vascular catheter care bundle in the Pediatric Nursing Service, Chiang Mai University Hospital, Thailand

Abstract

Objective The main purpose of this study was to compare the outcomes and nurse compliance before and after implementation of peripheral vascular catheter (PVC) care bundle.

Methods This study was conducted at Maharaj Nakorn Chiang Mai Hospital. The samples included children and infants admitted to pediatric wards, with pediatric nurses. Four thousand seven hundred and eight peripheral catheter insertion sites were evaluated, and 140 registered nurses were observed for compliance to the peripheral vascular catheter care bundle. Data were collected from October, 2011 to August, 2012. The research tools consisted of the following: 1) The Peripheral Vascular Care Bundle by the Health Protection of Scotland, 2) The Complication Assessment Form, and 3) The Nursing Action Observation Form. The peripheral vascular care bundle was implemented by providing training and knowledge for pediatric nurses. The establishment of strategies to promote the implementation of care bundle, support of equipment, and provision of feedback, were included. Data were collected before and after implementing the care bundle. The Chi-square statistical test was used to compare data.

Results The results showed that after implementing care bundle; there were no infections at the catheter insertion sites and no bloodstream infections. The infiltration rate decreased significantly from 5.6 to 0.8 episodes per 100 PVC insertions (p< 0.001), and the phlebitis rate decreased significantly from 0.6 to 0.2 episodes per 100 PVC (p =0.02). Overall nurse compliance with PVC bundle was 58.6%, which improved significantly to 77.3% after intervention (p< 0.001).

Conclusions The findings indicated that implementation of the PVC bundle reduced complications in children and infants who received a peripheral vascular catheter. The PVC bundle should be promoted in nursing services, for sustainable and best nursing practices.