Abstract
Background: Pediatric intravenous (IV) cannulation is a frequent yet challenging clinical procedure, especially in younger populations with smaller veins and high anxiety. Inconsistent practice, lack of standard protocols, and inadequate staff training contributed to poor first-attempt success rates, increased complications, and decreased patient satisfaction in our pediatric unit.Objective: To improve IV cannulation outcomes in pediatric patients by standardizing procedures, training staff, reducing complication rates, and enhancing overall satisfaction through a structured quality improvement program.
Methods: A prospective pre-post interventional study was conducted in Wadi Al Dawasir General Hospital, Riyadh Region, Kigdom of Saudi Arabia. Baseline data included IV success rates, complication rates, staff protocol adherence, and patient/parent satisfaction. Interventions included development and dissemination of a standardized protocol, competency-based nurse training, introduction of ultrasound guidance, and enhancement of pain management practices.
Results: Post-intervention, first-attempt success improved from 64% to 88%. Infiltration rates decreased from 22.5% to 8.3%, phlebitis from 12.5% to 2.3%, and protocol adherence rose from 62% to 93%. Parent satisfaction improved from 3.2 to 4.6 (on a 5-point scale), and monthly occurrence variance reports (OVRs) dropped from 9 to 2.
Conclusion: The structured quality initiative significantly improved pediatric IV cannulation outcomes. Sustained results require continued staff education, real-time monitoring, and supportive infrastructure.