title: [Reducing the Incidence of Phlebitis Related to Intravenous Injection in Pediatric Patients].
abstract: OBJECTIVE
  Peripheral venous catheter (PVC) is commonly used to provide nutrition and medicine to pediatric inpatients. Phlebitis is a common side effect of PVC insertion. Over 90% of pediatric patients in the paedi-atric medical ward at the Chang Gung Memorial Hospital (CGMH) receive PVC insertion, with an incident rate of phlebitis of 5.07%. Common cause factors of phlebitis are: insufficient sterilization time, inappropriate methods used to fix the PVC, the use of fixtures that loosen easily, high re-fix rates, and inadequate wound care after catheter removal.
  
  
  OBJECTIVE
  The purpose of this project was to reduce the incidence rate of PVC-insertion-related phlebitis in children from 5.07% to 2.5%.
  
  
  METHODS
  A one-week clinical observation identified the re-inserting / re-fixing of existing PVCs as the principal cause of phlebitis in the CGMH paediatric ward. Therefore, the researchers modified the catheter care bundle based on a review of the literature and the suggestions of clinical pediatric experts. Modifications included applying 2% chlorhexidine to sterilize the insertion site; using a new, non-woven fabric splint to fix the PVC site; providing cartoon-themed waterproof dressings for the first bath after the removal of the PVC; and setting standard operating procedures (SOPs) for PVC insertion and catheter removal.
  
  
  RESULTS
  After applying these modifications, the incident rate of phlebitis in children with PVC insertions decreased from 5.07% to 2.08%.
  
  
  CONCLUSIONS
  The application of 2% chlorhexidine reduces the waiting time for sterilization; the purpose-designed splint strengthens the fixation of the PVC; and the development of the SOPs for PVC insertion and post-removal catheter care reduces the risk of phlebitis. The combination of these strategies effectively reduces the incidence of phlebitis and improves the nursing care quality.
authors.affiliation: Department of Nursing, Linkou Chang Gung Memorial Hospital, Taiwan, ROC.
authors.forename: Yen-Hua
authors.initials: YH
authors.lastname: Cho
authors.affiliation: Department of Nursing, Linkou Chang Gung Memorial Hospital, Taiwan, ROC.
authors.forename: Li-Ling
authors.initials: LL
authors.lastname: Yen
authors.affiliation: Department of Nursing, Linkou Chang Gung Memorial Hospital, Taiwan, ROC.
authors.forename: Kai-Ling
authors.initials: KL
authors.lastname: Yu
authors.affiliation: Department of Nursing, Linkou Chang Gung Memorial Hospital, Taiwan, ROC.
authors.forename: Chun-Chu
authors.initials: CC
authors.lastname: Chang
authors.affiliation: Department of Nursing, Linkou Chang Gung Memorial Hospital, Taiwan, ROC. egg50128@cgmh.org.tw.
authors.forename: Hsuen-Ling
authors.initials: HL
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007262:Infusions, Intravenous / Q000009:adverse effects*; D008297:Male; D010689:Phlebitis / Q000453:epidemiology / Q000517:prevention & control*
keywords: pediatric patients; peripheral venous catheter; phlebitis