The effect of care bundle in preventing the frequency of peripheral intravenous catheter-related infiltration and phlebitis in the pediatric emergency department

Aim: This study was conducted to evaluate the effectiveness of a care bundle developed to prevent infiltration and phlebitis associated with peripheral intravenous catheters (PIVCs) in children. Method: The study was designed as a quasi-experimental research and included 200 children hospitalized in a pediatric emergency clinic (Standard Care Group = 100, Care Bundle Group = 100). Data were collected using the Patient Identification Form, Nurse Identification Form, Visual Infusion Phlebitis Assessment Scale (VIPAS), and Pediatric Peripheral Intravenous Infiltration Scale (PPIIS). In the Standard Care Group, PIVC care was performed according to the clinic's routine procedures. Subsequently, the "PIVC Safe Care Bundle" steps were applied. These steps included training on Peripheral Intravenous Catheter Management, adherence to hand hygiene and aseptic techniques, limiting attempts to no more than two per practitioner, using 2% chlorhexidine and 70% alcohol-based skin antiseptics for asepsis, and securing the catheter with hydrocolloid transparent adhesive tape. Results: The descriptive and catheter-related characteristics of children in both groups were similar (p>0.05). The pediatric nurses' gender, education level, professional experience, and pediatric emergency experience were also similar (p>0.05). The infiltration rate was higher in the Standard Care Group (46%) compared to the Care Bundle Group (25%) (p<0.05). There was no significant difference between groups in phlebitis incidence (p>0.05), but the mean phlebitis score was higher in the Standard Care Group (0.09 ± 0.29) than in the Care Bundle Group (0.02 ± 0.14) (p<0.05). The number of PIVC insertion attempts did not differ significantly between groups (p>0.05). The first-attempt success rate was higher in the Care Bundle Group (70%) than in the Standard Care Group (41%) (p<0.05). The average number of catheter insertion attempts was significantly lower in the Care Bundle Group (1.43 ± 0.76) compared to the Standard Care Group (1.73 ± 0.72) (p<0.05). Conclusion: The PIVC Safe Care Bundle applied during PIVC procedures in children treated in the pediatric emergency department was found to reduce infiltration rates, increase PIVC procedure success rates, and the phlebitis scores in the group receiving the care bundle were statistically significantly lower. It is recommended to integrate the PIVC Safe Care Bundle, developed to prevent infiltration and phlebitis, into PIVC care practices in pediatric emergency departments July 2025, 114. pages. Keywords: Child, peripheral intravenous catheter, infiltration, phlebitis, success rate, care bundle