SHM Converge Scientific Abstract ePoster Gallery-Pediatric Vascular Access: Unique Challenges and Opportunities for Improvement

Pdf Summary

This pediatric quality improvement project examined challenges in obtaining IV access in a 110-bed children’s hospital. Because children often have difficult vascular access due to physical and behavioral differences, repeated needlesticks can cause trauma and delay care. The hospital lacked a standardized method to predict difficult IV placement, a clear escalation pathway, and dedicated staff support.<br /><br />The project’s goals were to reduce the number of attempts needed for successful IV placement and improve comfort measures during placement. Over two months, the team collected baseline data on all IV placements in patients aged 0–22 years, including the number of attempts and resources used. They also trained nurses and residents in ultrasound-guided IV placement.<br /><br />Baseline results showed 777 patients received 1,010 IVs, requiring 1,266 needlesticks. Some patients needed many attempts: 6% required four needlesticks and 0.5% required ten or more. Children 2 years old and younger needed significantly more attempts on average than those aged 3–21 years (2.1 vs. 1.4 attempts; p < 0.00001). Staff from other units, especially the Pediatric Intensive Care Unit, were often pulled to help with IV access, creating strain on staffing. So far, 30 nurses and eight residents completed ultrasound training.<br /><br />Based on these findings, the team developed and implemented a pediatric vascular access guideline and escalation pathway through multidisciplinary collaboration. Future plans include ongoing education and possible expansion of a specialized vascular access service team.<br /><br />Overall, the project highlights that young pediatric patients are especially vulnerable to multiple IV attempts and that standardized protocols, ultrasound use, and specialized staffing may improve both care quality and efficiency.

Asset Subtitle

Weijen W. Chang

Meta Tag

Author List Erin Sevilla, Kristen Whitehead, Lauren Sweetser, Michelle K. Whitney, Nicole Nagata, Patricia A. Fontaine, Shannon Rowland, Weijen W. Chang

Category Innovations

Concept Pediatric Vascular Access

Concept Standardized Guideline

Concept Ultrasound-Guided Peripheral Intravenous Catheter

Concept Difficult Vascular Access

Concept Specialized Vascular Access Support

Distinguished Non-Finalist

Presenter Organization Nemours Children's Hospital Florida

Presenting Author Weijen W. Chang

Track Pediatric

Keywords

pediatric vascular access

intravenous access

children's hospital

ultrasound-guided IV

needlesticks

quality improvement

difficult venous access

escalation pathway

nursing training

specialized vascular access team

Pediatric Vascular Access

Standardized Guideline

Ultrasound-Guided Peripheral Intravenous Catheter

Difficult Vascular Access

Specialized Vascular Access Support