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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)