Evaluation of pediatric nurses' knowledge attitudes and practices on infiltration and extravasation

Peripheral venous catheters (PVC) are among the commonly used methods in the application of intravenous (IV) treatment in pediatric patients. However, complications such as infiltration and extravasation are serious problems frequently encountered in PVC application. These complications may cause disruption of intravenous treatment, damage to surrounding tissues and serious health problems. Such complications can be prevented with correct knowledge, appropriate attitude and effective practices. This study was conducted to evaluate the knowledge, attitude and practices of pediatric nurses on infiltration and extravasation. The study was conducted in a descriptive and cross-sectional design. Data were collected from 250 pediatric nurses who worked in the clinics of Cengiz Gökçek Maternity and Children's Diseases Hospital between August and December 2023, who agreed to participate in the study voluntarily and met the inclusion criteria. Ethics committee approval, institutional work permit, and informed voluntary consent of the nurses were obtained for the conduct of the research. Data were collected using the Nurse Identifying Characteristics Form, Infiltration and Extravasation Information Form, Nursing Practices to Prevent Infiltration and Extravasation Form, and Attitude Scale Towards Preventing Infiltration and Extravasation. Independent samples t-test, one-way analysis of variance (ANOVA), Bonferroni and Tamhane multiple comparison tests, Mann Whitney U test, Kruskal Wallis H test and Spearman correlation analysis were used in data analysis. The mean age of the nurses was found to be 29.94±5.39 years. Of the participants, 64% were female, 75.2% had a bachelor's degree, and had been working as a pediatric nurse for an average of 6.24±4.97 years. 76.8% of the nurses received training on peripheral venous catheter application. The average score for the level of knowledge of the nurses regarding infiltration and extravasation was determined as 17.70±4.65. Although the general level of knowledge was found to be low, 81.2% of the nurses knew that catheter selection and appropriate catheter number affected the risk of infiltration and extravasation, and 81.6% knew that rapid and pressurized administration of intravenous fluid would not cause infiltration and extravasation. The total score of the Nurses' Attitude Scale Towards Preventing Infiltration and Extravasation was found to be 49.70±6.97. The clinical competence and technical skills sub-dimension was measured as 13.31±2.65, and the self-confidence and self-efficacy sub-dimension was measured as 8.90±2.19. The total score of nursing practices for infiltration and extravasation was 34.82±3.83, and the catheter site assessment sub-dimension (16.20±2.55) and the catheter care and infusion therapy sub-dimension (11.53±2.22) were determined as the areas with high scores. As a result, infiltration and extravasation are important complications in intravenous treatment. It is critical for nurses to develop their knowledge, attitudes and skills about peripheral venous catheter application in preventing these complications. It is recommended that nurses be supported with regular in-service training programs in order to increase their effectiveness in predicting and preventing these complications. Keywords: Nurse; intravenous; infiltration; extravasation; knowledge level.