Standardizing IV Cannulation Procedures to Improve Pediatric Patient Outcomes

Abstract

Background: Intravenous (IV) cannulation is an essential yet challenging procedure in pediatric care, often associated with high complication rates and patient distress. Variability in technique and lack of standardization contribute to low first-attempt success and increased infiltration and phlebitis.

Objective: This quality improvement initiative aimed to enhance pediatric IV cannulation outcomes by standardizing protocols, improving staff training, and promoting consistent use of pain management strategies.

Methods: A pre–post intervention study was conducted in the pediatric unit of Wadi Al-Dawasir General Hospital, Riyadh Region, Kigdom of Saudi Arabia, over thre months. Baseline data were collected on cannulation success, complications, staff protocol adherence, and patient/parent satisfaction. Interventions included developing and implementing standardized protocols, simulation-based nurse training, and integration of ultrasound guidance for difficult cases. Post-intervention audits assessed progress.

Results: First-attempt success improved from 64% to 88%, infiltration rates dropped from 22.5% to 8.3%, and phlebitis from 12.5% to 2.3%. Protocol adherence increased to 93%, and patient satisfaction rose from 3.2 to 4.6/5. Occurrence variance reports (OVRs) decreased from 9 to 2 monthly. Ultrasound use for difficult cases reached 20% and pain management implementation improved by 30%.

Conclusion: Standardization and targeted staff development significantly improved procedural outcomes and patient experiences. Sustaining these results requires continued monitoring, feedback systems, and institutional policy adoption.