Pediatric IV Insertions - Improving Satisfaction

Purpose:
To improve the Patient/Family satisfaction scores relating to the insertion of venous access devices in the pediatric population through the development and implementation of a pediatric venous access team.

Relevance/Significance:
Venous access in the Pediatric population creates an environment of high anxiety and significant stress for children, their families, and nurses. Consequently, satisfaction scores regarding insertion of venous access devices are commonly low. By creating and implementing a designated pediatric venous access team, nursing skills and efficacy are enhanced. This leads to a decrease in venous access attempts, decrease in anxiety and stress, and an increase in patient/family/nursing satisfaction.

Strategy and Implementation:
The nurses and ARNPs trained in pediatric ultrasound guided peripheral IV and PICC insertions work in various departments and were not immediately available to provide advanced skilled venous access for the pediatric population. Meetings were held regarding this issue. Hospital leadership assisted in developing a business plan to initiate the creation of the pediatric venous access team and opening two RN positions. An experienced pediatric vascular access RN was assigned to provide education and training. The adult venous access team provided guidance and opportunities to obtain competencies utilizing the adult population. Revenue integrity assisted in determining cost effectiveness of specialized training and capturing charges for difficult venous access. Algorithms and processes were developed for the primary care nurses to utilize when consulting the pediatric venous access team.

Evaluation:
Prior to the implementation of the venous access team, the Press Ganey Trends for “Skill of the IV starter” were 81.1%. After the implementation of the venous access team the trends increased to 97.9%. Primary care RNs have expressed an increased in job satisfaction related to a decrease in stress with difficult IV insertions and lab draws.

Implications for Practice:
The pediatric venous access team will continue to monitor demands and trends to expand the team, identify areas to further improve the quality of patient care and satisfaction, evaluate the effects on the primary care nurse's environment, and continually enhance their professional practice.