Nurses' Experience on Peripheral Intravenous Catheter Insertion, Care and Complications in Pediatric Patients

Background Peripheral intravenous catheter (PIVC) is a common invasive procedure carried out by nurses which is more challenging in children. Given the lack of exploration of nurses' experiences related to PIVC initiation, care and management of complications in children, this study aimed to explore paediatric nurses' experience on PIVC initiation, care and management. Methods Exploratory qualitative study was conducted in Nepal. Three focus group discussions were carried out among 14 nurses working in paediatric in-patient unit of a government teaching hospital between November and December 2023, and thematic analysis was done. The Consolidated Criteria for Reporting Qualitative Research guideline was used. Results Nurses face difficulties in initiating PIVC in children which is increased by parental pressure and emotional response; staff turnover and shortage; the wish for vein visualization technology was explored. Significant number of children develop complications and timely recognition, parental involvement and infection prevention are important to reduce possible risk factors. We identified three interrelated themes: 1) Responsibility and challenges in initiating and maintaining PIVC in children. This theme explains four sub-themes; responsible, mix experience of own and parents' emotional response, difficulty in initiating, and facing multiple challenges. 2) Complications of PIVC and possible risk factors: this theme contains four sub-themes; complications in children, possible risk factors experiences, need of parental involvement, and importance of timely recognition. 3) PIVC care practice, realization of gap and hindrances experienced: it includes knowledge and practice gap, evidence-based practice need, staff-patient ratio, patients' socio-economic status, supply and economic barrier to health care and management practice, and complication management and possible preventive ways. Conclusion Nurses feel responsible to PIVC maintenance. Nurses has realization of lack of routine care and standard practice including infection prevention, which is linked to resource limitations, staff shortage, turnover, and patient affordability. Findings have practical implications for nurses, healthcare-team, and hospital for quality care of pediatric-patients.