Files
Download Full Text (645 KB)
Description
EBP
Background: PIV catheters are the most placed device in the NICU requiring frequent attempts, with a brief duration due to complications which indicate removal before completion of treatment. PIVs used for treatment have a patient safety risk of PIVIE; the severity can be mild, moderate, or severe depending on the swelling and tissue damage. PIVIE rates are one of the patient quality outcomes and are increasing in the NICU. Considering the increased risks of long-term consequences from tissue injury associated with PIVs, MCD may improve quality and patient outcomes.
Problem: PICOT question: (P)For eligible neonates in a level IV NICU, (I) will implementation of midline catheters, (C) compared to the use of non-midline PIVs, (O) reduce the incidence of serious PIVIEs, (T) six months after full implementation.
Conceptual Framework:
Iowa Model Revised: Evidence-Based Practice to Promote Excellence in Health Care
Literature Review
- Midline catheters are longer than standard PIVs and offer longer dwell times.
- Common placement of midline catheters is for difficult access.
- Use methods to select the appropriate vascular access device for patient’s needs.
- Validates standard PIVs are the most placed device in the NICU yet have a risk for complications and patient harm.
- Regarding effectiveness in reducing vascular injuries in NICU patients, midline catheters need further reported data.
Methodology
- Revise NICU Appropriate Line Algorithm to include midline catheters.
- Product trial Benchmarking
- Create guidelines for use of midline catheters
- Develop education for staff.
- Utilize specialized team for line insertion and management.
- Data collection of PIVIEs and midline performance
Data Analysis
Analyze and compare number of PIVIEs in the NICU 6 month pre- and post-implementation.
Interpretation
Midlines have longer dwell times, less complications, and decreased PIVIE events.
Publication Date
9-27-2024
Keywords
EBP, Evidence-Based Pracitce, Evidence-Based Nursing, Catheter, Vscular Access Devices, NICU
Disciplines
Pediatric Nursing
Recommended Citation
Lanehart, Kymeyone; Palmer, Rebecca; Tidwell, Jeri; Yallapragada, Sushmita; Campbell, Courtney; David, Lebanon; and Doerge, Katie, "Midline Catheter Implementation: Expanding Vascular Access Options in a Level IV NICU to Decrease Vascular Injury" (2024). 2024. 35.
https://scholarlycollection.childrens.com/nursing-anf2024/35
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
