Arterial catheter maintenance in children: a best practice implementation project

INTRODUCTION: Arterial catheters are widely used in intensive care units for continuous hemodynamic monitoring and blood collection. Evidence-based practices for arterial catheter maintenance are not strictly followed by all medical staff in the pediatric intensive care unit. OBJECTIVE: This study aimed to improve compliance with evidence-based practices for arterial catheter management in critically ill children in a Chinese pediatric intensive care unit. METHODS: The JBI Evidence Implementation Framework was used to translate evidence into practice. The Integrated-Promoting Action on Research Implementation in Health Services (i-PARIHS) framework was used to identify barriers to compliance with best practices. An arterial catheter management strategy for critically ill children was developed based on the identified barriers, along with a simulation training module and a supply of 10-ml prefilled normal saline flush syringe. Field observations, a review of medical records, and interviews with medical staff and patients were used to assess baseline and follow-up audit compliance with best practices. RESULTS: Thirteen criteria were audited in the baseline and follow-up audits using 220 and 212 peripheral arterial catheters, respectively. In the follow-up audit, compliance with all criteria increased and the indwelling time of the peripheral arterial catheter was prolonged. CONCLUSIONS: The JBI Evidence Implementation Framework was used to improve compliance with the best practices. Future audits should be conducted to sustain the evidence-based behavior of all medical staff. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A642.