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Table 5 Nurses’ adherence to the Clinical Practice Guideline before and six months after intervention

From: Clinical practice guideline on the prevention and management of neonatal extravasation injury: a before-and-after study design

Interventions Adherence (%) p-value*
Pre- intervention Post- intervention
1. Assess signs and symptoms of PIVE. 88.68 100 NS
2. Assess peripheral IV infusion site/s hourly. 100 100 NA
3. Identify high-risk drugs/infusates for PIVE. 66.04 100 <0.001
4. For high-risk drugs/infusates, assess peripheral IV site/s every 10 minutes. 35.85 100 <0.001
Administer high-risk drugs/infusates via a CVC. 83.02 100 NS
5. Administer parenteral nutrition via a CVC. 96.23 100 NS
6. Assess patency of peripheral IV device/s prior to drug administration. 100 100 NA
7. Secure peripheral IV device with transparent dressing. 100 100 NA
8. Splint extremities with a peripheral IV device in situ. 100 100 NA
9. Assess patient for ECL. 15.09 71.70 <0.001
10. Confirm correct position of CVC tip. 69.81 100 <0.001
11. Initiate actions for managing PIVE at once. 98.11 100 NS
12. Grade PIVE severity with infiltration scale. 0 96.23 <0.001
13. Implement management of Grade 1 and 2 PIVE. 84.91 98.11 NS
14. Notify physician for Grade 3 and 4 PIVE. 66.04 100 <0.001
15. Administer Hyaluronidase for PIVE caused by non-vasopressor drugs/infusates. 39.62 100 <0.001
16. Administer Phentolamine for PIVE caused by vasopressor drugs/infusates. 1.89 90.57 <0.001
17.  Initiate non-pharmacological pain relief for extravasation injuries. 77.36 100 <0.001
18. Offer pharmacological pain relief for extravasation injuries. 79.25 100 0.001
19. Observe PIVE with intact skin hourly for 12 hours. 5.66 90.57 <0.001
20. Remove the CVC for ECL. 77.36 81.13 NS
21. Initiate nursing interventions to manage ECL. 16.98 81.13 <0.001
22. Consult wound nurse for wound management. 11.32 90.57 <0.001
23. Document PIVE or ECL on extravasation record. 0 100 <0.001
24. Report extravasation injury to parents. 7.55 96.23 <0.001
25. Update progress of extravasation injury to parents. 1.89 98.11 <0.001
26. Incident reporting. 0 90.57 <0.001
  1. Abbreviations:CVC Central venous catheter, ECL Extravasation from a central line, IV Intravenous, NA Not applicable, NS Not significant, PIVE Peripheral intravenous extravasation
  2. *Comparisons of nominal data: McNemar test; Level of significance (p < 0.002)