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Gwen Irwin
Pediatric IV site assessment and documentation

For the pediatric nurses, how often does your policy and procedure require IV site assessment and documentation of that assessment?

I have seen responses on the NACHRI listserve about hourly checks, but I am wondering if they really assess the site, uncover it to actually assess/view the site, and document.

Where would be the standard/study that leads to hourly site checks being best practice?  Or is it because it makes sense and has always been done that often.  Just trying to learn more about pediatric infusion therapy.

Could the practice be dependent on the age of the patient?  Hourly for NICU and infants, every 2 for others?

Gwen Irwin

There is no published
There is no published standard that states a specific time frame for assessing any age group. It depends upon the types of therapy, types of catheters, etc and each facility must make their own policy. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Gwen Irwin
OK, no published

OK, no published standard.

So, pediatric nurses, why have hourly checks been the standard (as I understand from pediatric hospitals)?


Angela Lee
We do have written in our
We do have written in our P&P hourly assessments on continually infusing PIVs.  I consider site assessments as assessing that area where the catheter tip resides in the vein because that is usually where evidence of infiltration, phlebitis, tenderness, etc. occur.  In pediatrics we do not do routine dressing changes so to take a dressing off every hour to assess the insertion site would create more problems than it would prevent or identify.  i always emphasis to the staff the rapidity that a problem can occur and worsen in peds and neonates, hence the frequent checks.  In addition it is imperative that the area at the catheter tip (3/4 to 1 or 1/4 inch above insertion site) be clear for inspection--no tape or other cover-ups.  Then there is no need to alter the dressing.
Gwen Irwin
Thanks, Angela.  I didn't

Thanks, Angela.  I didn't mean to take the dressing off to view the site.  We also don't do routine dressing changes or site changes on pediatric patients.  We often see the area that you describe as catheter tip area covered.  Sometimes with tape that obscures the site and sometimes IV house that may have too much tape to see the site. 

anna liang
our p&p states every 2 hours
our p&p states every 2 hours check. it makes sense for PICUs & ICN for hourly check -- but it is not wirtten in the p&p.
for floor staffs, if they are required to do hourly check and then chart the finding, do they have the time for such frequent charting?

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