(N4) Part 1. Don’t Accept the Way it’s Always Been: Change the Way You Monitor IVs for Infiltrations Before it’s Too Late. Part 2. Journey to ZERO Harm: Strategies to Improve Recognition and Elimination of Serious Peripheral Intravenous Extravasations

Part 1.

Evidence-based care bundles to reduce intravenous complications exist for all patient groups including neonates. Peripheral intravenous catheter failure and complications like peripheral IV infiltration/extravasation (PIVIE) are majorly detected by the clinicians’ eyes and assessed by observation tools. Evidence supporting the use of technological aids in neonates is still new. We report on two neonatal pilot studies and 4 years of clinical peripheral IV data. Comparing either an established observation tool or adding sensor-technology as an adjunct intervention showed a significant correlation between the occurrence of PIVIE and not adding sensor-technology. The risk of developing severe PIVIE increased significantly if sensor-technology was not used. This supports the use of sensor-technology as a safe and effective intervention for early PIVIE detection. It was noted, that data showed a decrease in PIVIE severity from 13.8% prior to use of sensor technology to 3.0% severity after adding sensor-technology to the standard practice. This implicates a significant improvement in early detection of PIVIE and the outcome for neonatal vascular access.

Part 2.

Peripheral Intravenous Catheters (PIVs) are one of the most common vascular access devices used in the pediatric patient population. Like many invasive procedures, PIVs have a broad range of complications including, but not limited to phlebitis, infiltrations, and extravasations. PIV related complications have become a significant patient safety problem for many healthcare organizations. At a large academic pediatric institution, continued safety concerns surrounding PIV complications prompted the creation of process improvement strategies to address identification, reporting, and elimination. The purpose of this presentation will be to discuss the process improvement strategies created improve reliable identification and reporting of PIV complications. Additionally, we will discuss interventions implemented across pediatric and neonatal networks to address rising numbers of serious extravasation.