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Description

Prompt, dependable delivery of vasoactive medications can be life-saving in the pediatric population. Research shows that short-term delivery of vasoactive medications through a peripheral IV (PIV) is safe and effective, yet nurses in our pediatric intensive care unit (PICU) continue to have concerns about the risk of patient harm related to extravasation. The purpose of this project is to develop and incorporate into practice a standardized algorithm to assist in safely administering vasoactive infusions via PIV. After a thorough literature review, we assembled an interdisciplinary team to create a plan to address these concerns. Our team held that the most effective way to listen and combat the underlying issues at hand would be to develop a process map that would support safe PIV vasoactive administration and encourage advocating for a central line for their patient when specific criteria are not met. This process map would provide physicians with evidence-based practice guidelines to support the use of PIVs when administering vasoactives short-term as well as recommend limits to PIV delivery of these high-risk medications. Our work group drafted and distributed a pre-intervention survey to gauge self-identified barriers to PIV vasoactive administration between bedside nursing and providers. We then utilized that feedback in our development of the process map. Because extravasations were a concern from our bedside staff and are a reportable measure of patient safety, our team will continue to track the extravasation rate both pre- and post-intervention. We plan to distribute our post-implementation survey this winter and we are hopeful that this standardized methodology for determining the line access necessary for vasoactive infusions will reduce concerns from bedside nursing staff, align nursing and physician strategy, improve overall knowledge of evidence-based safe practices, and improve patient care. In the future, we plan to expand this project hospital-wide.

Publication Date

2023

Standardizing Access Parameters for Vasoactive Infusions

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