Reducing Complications of IV Cannulation: A Quality Improvement Project
Dr. Bhavana Bhushan Lakhkar,
Department of Paediatrics, Sawangi (Meghe), Wardha-442004, Maharashtra, India.
Introduction: Intravenous (IV) cannula insertion is the most common invasive procedure in Neonatal Intensive Care Unit (NICU). A large number of complications are due to cannula itself, increasing the morbidity and sometimes duration of NICU stay in newborn.
Aim: To find the impact of structured training program for nurses and residents on IV cannula related complications.
Materials and Methods: The study was done in two phases with a structured training program (of doctors and nurses) after first phase. In first and second phase, the newborns with IV cannula insertion (each cannula separately) were included in the study. Those with no parental consent or having bleeding disorder were excluded. The site was observed for complications, duration of stay and reason for removal, after recording the details of baby.
Results: Total of 190 babies with 300 IV lines and 120 babies with 373 IV lines were the subjects in two phases. Significant changes were observed after training program. Number of IV insertions (2.5 to 1.9 per baby) and complications (190, 63% to 125, 33.5%, p-value <0.0001) significantly reduced. Indicated removal (98, 32.6% to 247, 66.4%, p-value <0.00001) and duration of stay (2.5 days to 5 days, p-value <0.00001) improved. Extravasation was the most common complication which also significantly reduced.
Conclusion: Training of staff nurses and residents in IV cannula insertion and maintenance should be a part of hospital activities for better outcome.