Quality Improvement in Nursing

Chamberlain College of Nursing NR392 Quality Improvement in Nursing

Course Project Milestone 1 Template

For Use SEPT 2018

Directions: Prior to completing this template, carefully review Course Project Milestone 1 Guidelines paying particular attention to how to name the document and all rubric requirements. After saving the document to your computer, type your answers directly on this template and save again. This assignment is due by Sunday end of Week 1 by 11:59 p.m. Mountain Time.

Your Name: Nickflor Jean

Assignment Criteria Your Answers:

(NOTE: See Milestone 1 Grading Rubric for details required in each area.)

Nursing Care Issue and Outcome

30 points

Nursing Care Issue: My nursing care issue is I.V. infiltration in pediatrics

Outcome: To reduce the number of IV infiltration in my unit by 50% in the next 6mths.

Details of the Issue

45 points

IV infiltration can be explained as the leakage of medications or IV fluid into the neighboring cells and tissues. It is mostly caused by factors such as displacement of the catheter or an improper placement. The catheter can be displaced due to the movement of the patient. I.V. infiltration takes place when nonvesicant drugs escape from the veins and leak out to the neighboring cells and tissues. IV infiltration has various side effects such as discomfort, compartment syndrome or a need to reinsert the intravenous catheter. Such acts will likely increase the time the patient is hospitalized and/or permanent damage to children.

Some of the signs and symptoms of this issue include blanching and cool skin, a decrease or stopping of the flow rate, burning, swelling and discomfort.

There are a number of measures that can be utilized to prevent IV infiltration from happening. Some of the preventive measures include but not restricted to selecting the best site for IV infiltration and avoiding places of flection.

· Using the right venipuncture method

· Regularly observing the IV site and documenting

· Inform the patient to report any tenderness or inflammation at the site

· Re-train nursing staff in IV initiation, maintenance, documentation and Identification of all risk factors

Reason Issue Selected

25 points

I chose this issue because it is of significant impact to the patients and their families if it occurs. For example, when a patient stays longer in hospitals, families will incur more costs when indeed it can be prevented. I have also mentioned the problem of permanent damage such as nerve damage and muscle damage depends on the medication or the type of fluid. I.V. infiltration can also lead to the damage of the nerves. For example, if the catheter is in the hand and a nerve is damaged, in addition to the other effects, the patient will lose some of his functioning of that hand or experience a feeling of numbness (Goldenholz, 2017). These are negative consequences which we should try to avoid at all costs.

I’ve been working as a nurse in the PICU for the past 3 years and every year we experience several cases of IV infiltration usually caught in the early stages however, that change last months alone we had two severe cases of IV infiltration which led to compartment syndrome and another patient having to stay with us 5 days longer then need be.

References

Bonsall, L. (2015). Complications of Peripheral I.V. Therapy. Retrieved From

https://www.nursingcenter.com/ncblog/february-2015-(1)/complications-of-peripheral-i- v-therapy

Goldenholz, S. (2017). Infiltrated IV complications of Nerve damage & Cellulitis. Retrieved

From https://www.livestrong.com/article/231265-infiltrated-iv-complications-of-nerve-damage-cellulitis/

NR392 Course Project Milestone 1 Template.docx 9/2018 CJM/VH 3