Prevention of Injuries in Children with a Peripheral Intravenous Catheter: A Modified Evidence-Based Nursing Practice Guideline

Abstract

Many children in African hospitals need a peripheral intravenous catheter (PIVC). Babies and children are particularly susceptible to serious harm from PIVC-related injuries. Nurses often regard a PIVC as a routine, low-risk intervention. Globally recommended practices include establishing a structured care pathway, recognising that PIVC management begins before insertion. Evidence-based care for children with PIVCs reduces complications and healthcare costs. Existing guidelines on managing PIVCs in infants and children are generally written for higher-resourced settings or are not specific to a paediatric population. This study aimed to review existing practice guidelines to provide accessible and implementable guidelines for caring for hospitalised babies and children up to the age of 13 years, in lower-resourced paediatric in-patient health facilities in Namibia. We applied a structured process for modifying existing high-quality guidelines developed in higher-resourced settings for implementation in lower-resourced contexts. This process involved identifying suitable guidelines for modification and rigorous guideline modification, resulting in a context-specific guideline. The modified guideline ensured that recommended practices related to pain management, difficult insertions and infection prevention are implementable. However, seeing PIVCs as unlikely to cause serious harm can lead to insufficient assessment and surveillance of PIVC injuries. We therefore produced a user-friendly guideline focused on high-impact areas of nursing practice, emphasising that nurses can avoid injury to children by properly managing a PIVC.