Document Type

A3

Executive Sponsor(s)

Faye Weir

Publication Date

Spring 5-17-2024

Institution/Department

Maine Medical Center, Barbara Bush Pedicatric and PICU

Abstract

PIVIE (Peripheral Intravenous Infiltration & Extravasation) can have devastating effects, especially in the pediatric population. The condition may disrupt vasculature severe enough for permanent skin and tissue loss that can lead to impaired limb function due to severe scarring. Problem: No standardized process existed either to prevent or review these events at Barbara Bush Children’s Hospital at Maine Medical Center prior to the study. PIVIEs were measured through the event reporting platform and only severe PIVIEs were being documented in this report. All infiltrations (1-4 on the infiltration scale) should be measured for accurate benchmarking. Occurrences in the electronic medical record were 36 times greater for PIVIEs annually than data indicated in the event reporting platform, which is in-line with SPS national rates. Approach: A multidisciplinary team developed new reports documenting PIVIE incidence, which were used to set a baseline rate for the pediatric departments. We built two reports using EMR data with one to determine “IV removal reason” and another to define “infiltration scale” to cross-reference occurrences. The reports are also compared to event reporting platform occurrences for PIVIE. The workgroup devised a standardized workflow for documenting and responding to PIVIEs. An education plan was developed to communicate this workflow to the pediatric nurses. We will start these changes officially in the upcoming weeks and will continue to track data for the next several months. Auditing is planned both in-person and via chart audits. Data from new reports will allow cross-referencing proper documentation of events as well as improved understanding of severity of the events. We will compare rates and severities pre and post education rollout.

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