Nurse-driven innovation in pediatric care: Usability and securement performance of a novel tubing anchor in simulated clinical scenarios

PURPOSE: Safe tubing securement is critical in pediatric care, as unplanned extubations can lead to significant morbidity. This study developed and evaluated a novel Pediatric Integrated Tubing Anchor (PITA) device designed to improve securement efficiency and usability compared with a conventional tubing anchor (CTA). METHODS: Guided by a user-centered design thinking process, the PITA device was developed to integrate endotracheal, nasogastric, and bite block securement. A randomized crossover trial was conducted with 77 nurses using simulated stable and agitated pediatric patient scenarios. Each nurse applied both the CTA and PITA devices during the simulations. RESULTS: The PITA device significantly reduced securement time compared with the CTA in both stable (mean difference: 92.1 s, p < .001) and agitated scenarios (mean difference: 160.9 s, p < .001). The PITA device also demonstrated superior tubing stability under load and achieved significantly higher usability scores on the Tubing Care Usability Scale (62.0 vs. 47.9, p < .001). CONCLUSION: The nurse-developed PITA device offers a more efficient, stable, and user-friendly method for tubing securement. Its clinical adoption may help reduce unplanned extubations, prevent related complications, and save valuable nursing time, particularly in high-risk situations. These findings support the value of empowering frontline nurses as active contributors to healthcare innovation. CLINICAL IMPLICATIONS: Findings from this study demonstrate the importance of nurse-driven, user-centered innovation in developing pediatric-specific devices that enhance patient safety and workflow efficiency.