Impact of An Interventional Bundle on Complications Associated with Peripheral Venous Catheters in Children Admitted to A Cardiology Department

Abstract

Peripheral venous catheters (PVCs) are frequently inserted in children. However, their use is associated with difficulties during insertion and complications during management. Our objective was to assess an interventional care bundle for insertion of PVCs in pediatric patients admitted to a cardiology department. Over a 10-month period, we prospectively included pediatric patients with a PVC inserted in the cardiology department. The study period comprised a 4-month pre-intervention period, followed by a 6-month post-intervention period, in which a preventive bundle was implemented. Data regarding catheter insertion, nursing experience, and complications were collected. Patients were monitored daily until catheter withdrawal. We included a total of 30 and 41 patients with 50 and 83 PVCs inserted during the 2 periods, respectively. Most PVCs were inserted in the forearm (36.8%). Younger patients experienced more severe pain at insertion (p=0.003), although this was significantly reduced after implementation of the bundle (34% vs 12%, p<0.001). No statistically significant reduction was observed in the frequency of phlebitis and of colonization in both periods (6.0% vs. 9.6% [p=0.53] and 6.6% vs. 12.3% [p=0.47], respectively). Conclusion: Our preventive bundle was able to reduce severe pain during insertion of PVCs. However, it was unable to reduce phlebitis and infection rates, suggesting that further preventive measures are needed to improve management of PVCs in children admitted to cardiology departments.