Factors affecting Intravenous Infiltration among Hospitalized Children

Abstract

Peripheral intravenous (PIV) insertion is one of the most common procedures undertaken for pediatric patients requiring short-term infusion therapy. Infiltration, which considered one of the most common complications of PIV insertion, may cause discomfort, pain, inconvenience or delay in treatment due to reinsertion of the IV catheter, or more serious negative consequences, such as tissue ulceration or necrosis. Such complications have not only increased the length of hospital stay and care costs for additional treatments, but also resulted in permanent damage and limitations of physical functions in pediatric patients. Nurses working at the children’ hospitals should consider the risk of IV infiltration for children receiving intravenous infusion therapy and make efforts to identify IV infiltration in high-risk children at an early stage to prevent damage. Therefore, this study aimed, firstly, to investigate the risk factors for intravenous infiltration among hospitalized children and, secondly, to develop clinical guidelines for nurses for early recognition, prevention and management of intravenous infiltration. A descriptive correlative research design was used. The study was conducted at pediatric inpatient medical and surgical wards of Children's University Hospital in Mansoura city, Egypt. The participants werehospitalized children (253) from less than one year to 16 years who received peripheral IV insertions.Interview questionnaire sheet was developed by the researcher to collect relevant data. The results indicated that the infiltration rate was 23.3% and it was from stage 1 and 2. Conclusion: the most important risk factors for infiltration were the child weight, previous experiences of insertion of peripheral catheter, dwell time, site of insertion, catheter size, repeated insertion on the same site, infusion of antibiotics and IV fluids. Recommendation:in future studies, it would be important to account for nurse-associated factors in the study design, including, educational status, experience of the nurses, the nurses' potential preference for a particular insertion site or method and catheter insertion skills.