Examining the effectiveness of 2 solutions used to flush capped pediatric peripheral intravenous catheters.

An evidence-based study examined the effectiveness of 2 solutions, heparin and normal saline, when used to flush capped pediatric peripheral intravenous (CPP IV) catheters. This experimental study assessed patency, redness, swelling, clotting, bruising, leakage, and patient pain after each intervention/flush. Study participants included 62 children (32 heparin and 30 normal saline) who had CPP IV catheters using 20-, 22-, or 24-gauge catheters. No statistically significant differences were found in IV catheter patency between children in the normal saline group and children in the heparin group. A postimplementation follow-up study with 30 patients who received normal saline only as a flush experienced no patency issues.

A multidisciplinary approach to determine heparin dosing in pediatric vascular devices.

In the health care community, nurses are important agents of change and vehicles for improvements in clinical practice and policy. Pediatric nurses empowered with the tools of evidence-based practice and clinical expertise collaborated in 2007 with other health care professionals to make changes in clinical practice for pediatric patients with vascular access devices (VADs). Nurses recognized that there was a need for a change in the heparinization policy for children with short- and long-term VADs. Data were methodically collected over a 1-year period on 500 VAD. Data collection demonstrated a range of VAD volumes that did not exceed 2 mL. The group analysis of the results gave support for changes in the volumes needed for heparinization. Establishment of appropriate heparin dosing based on scientific data led to a decrease in heparin used to maintain pediatric VAD patency and aided in lowering the risk of side effects in patients.