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Pediatric IV insertion

Currently in the process of improving our pediatric IV insertion satisfaction scores.  There are times when a child has multiple attempts before a successful line is placed.  What are your protocols for pediatric insertions?  Is there any particular training that is out there that you feel is the best?  Any words of wisdom from experience that have made your programs successful?

Thank you,

Angela Lee
Our current protocol is that

Our current protocol is that the floor nurse attempt the IV (2 attempts per nurse is our policy).  If unsuccessful the nurse may call the Swat nurse.  If that nurse is unsuccessful then the nurse calls me.  Clearly at this poin the patient could have experienced quite a number of attempts.  Therefore, the protocol is circumvented when the patient is known to be difficult or requests an "IV nurse".

I used to have nurses spend a clinical day with me during which I would teach them to place PIVs.  It was very well recieved by the staff.  However, when my staff was reduced so that I placed primarily PICCs, i was limited to also placing only the most difficult PIVs.  These are not good patients for new hires to stick and learn on so I had to stop the clinical experiences for the nurses.  As my staff increases, I hope to increase my coverage to more patients and re-instate that educational experience.

It is my belief that "hands on" under the tutelage of an experienced nurse is the best way to learn practice.  I know there are simulation models and computer programs available but I don't have much experience with them.  At least not the computer programs.  The models may be good for teaching technique initally but do not begin to simulate a real patient.  Perhaps someone else can share a successful training program.

it is also clear to me that not all nurses need to be sticking patients.  I have heard many times that if you're an RN you can and should be able to place an IV.  I disagree.  There are those for whom the skill comes easily and those who never quite get it no matter the time and effort invested.  They usually recognize that that is not a strong area for them and should never be forced to stick a patient they do not feel comfortable with.

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