The purpose of this study is to evaluate the impact of a training intervention aimed at nursing personnel on the appropriateness of the indication of long peripheral venous catheters in candidate pediatric and neonatal patients, comparing the clinical practice of nursing personnel before and after the intervention.
Study Design: Prospective, unicentric quality improvement study.
The study consists of three phases:
1. -Pre-intervention phase: prospective collection of data from routine clinical practice, with a descriptive character, in relation to the use of catheters Venous short peripheral and long. 2. -Educational intervention: structured training directed to nursing staff about indications, technique and care of the catheters Venous long peripherals, including specific training in the ultrasound assessment of the venous tree as a support tool for the selection of the most suitable vein for the cannulation of the catheter. 3. -Post-intervention phase: protocol implementation of use of catheters Venous Long peripherals and prospective data collection of all peripheral venous accesses (short and long) in order to evaluate changes in clinical practice and results after the intervention. Likewise, the post-intervention phase will include a follow-up period with the objective of evaluating the sustainability of the effects of the intervention over time.
The collection of data over a prolonged period is contemplated, can be extended up to 24 months after the intervention, to analyze the maintenance of the adequacy in the indication of peripheral venous catheters, the incidence of complications and the stability of the clinical results. In a complementary way, the maintenance of the knowledge acquired by the nursing staff and the adherence to the protocol in routine clinical practice will be assessed.
Study Population and Total Number of Patients: The study population is structured in two levels: professional population (intervention) and clinical population (pre- and post-intervention).
1. Professional population (intervention phase) The study population corresponding to the intervention phase will consist of the group of nursing professionals of the Pediatric and Neonatology Service of the Jiménez Díaz Foundation University Hospital , who participate in the training intervention on ultrasound vascular assessment, channeling of long peripheral venous catheters and implementation of the care protocol.
The service has a care staff of 21 nursing professionals (approximately 3 to 5 per shift), distributed among the pediatric hospitalization floor, Pediatric Intensive Care Unit (PICU) and Neonatology Unit.
Regarding their characteristics, the age of the professionals is approximately between 25 and 50 years, with an estimated average of around 35-40 years. Professional seniority varies between approximately 1 and 30 years of experience.
The training intervention will be offered to all staff of the Pediatric Service, although participation will be voluntary, so no sample calculation is established at this stage.
The following will be evaluated for this population: * Knowledge before and after training. * Satisfaction with training. * Satisfaction with the use of long peripheral venous catheters. * Adherence to the implemented protocol. 2. Clinical population: Hospitalized pediatric patients will be included, from birth to 17 years of age, admitted to the pediatric hospitalization unit, the PICU and the Neonatology Unit, who are expected to require intravenous treatment by peripheral line for more than three days and whose parents or legal guardians give informed consent to participate and informed assent in the case of patients older than 12 years.
Schedule and Expected Date of Completion: The study is expected to begin in September 2026 , subject to obtaining approval from the Research Ethics Committee. The development period of the study will extend until October 2028 , including the preparation phase, the collection of pre-intervention data, the implementation of the training intervention and the subsequent follow-up of the participants and pediatric and neonatal patients. The study includes a short-, medium- and long-term follow-up, as well as the closing phase, data analysis and writing of the final report. These dates are estimates and could be adjusted according to the evolution of data collection and clinical follow-up.
Nurses working in the Pediatric and Neonatology Service of the Hospital Universitario Fundación Jiménez Díaz (pediatric ward, Pediatric Intensive Care Unit or Neonatology Unit)
Voluntary participation in the training program on ultrasound-guided vascular assessment, long peripheral venous catheter insertion and implementation of the care protocol
Signed informed consent
Patients from birth to 17 years of age admitted to the pediatric ward, the Pediatric Intensive Care Unit or the Neonatology Unit
Nurses who do not wish to participate voluntarily in the study
Professionals from outside the Pediatric and Neonatology Service
Candidates for central venous access, due to the characteristics of the drug (pH and osmolarity) or to their underlying condition
Candidates for a midline catheter
Single group
Training program on long peripheral catheter insertion
BehavioralStructured educational program for pediatric nurses on the insertion and maintenance of long peripheral catheters. The program combines theoretical content and hands-on practical training. Content includes indications and device selection, insertion technique, aseptic technique, catheter securement and maintenance, and early recognition and prevention of complications such as phlebitis, occlusion, infiltration, and accidental dislodgement.
Percentage of Long Peripheral Venous Catheter Insertions With an Appropriate Indication
Percentage of long peripheral venous catheter insertions performed by participating nurses in pediatric and neonatal patients whose indication meets the unit's protocol criteria for long peripheral catheters. The appropriateness of the indication will be recorded at each insertion using an ad hoc data collection form. Calculated as (number of insertions with an appropriate indication / total number of long peripheral venous catheter insertions) x 100. The baseline pre-intervention period will be compared with each post-intervention data collection window.
Change From Baseline in Nurses' Knowledge Score on Long Peripheral Venous Catheters
Knowledge of participating nurses about long peripheral venous catheters (indications and device selection, insertion technique, aseptic technique, securement and maintenance, and prevention and early recognition of complications) will be assessed with an ad hoc questionnaire of multiple-choice items. The score is expressed as the percentage of correct answers (range 0-100%), where higher scores indicate greater knowledge. Results will be reported as the change from the pre-training score at each post-training time point.
Percentage of Peripheral Venous Catheters With at Least One Complication
Percentage of peripheral venous catheters in pediatric and neonatal patients cared for by participating nurses that present at least one complication between insertion and removal. Complications include phlebitis, infiltration/extravasation, occlusion and accidental dislodgement, assessed by nursing staff and recorded on an ad hoc data collection form. Calculated as (number of catheters with at least one complication / total number of catheters) x 100. The baseline pre-intervention period will be compared with each post-intervention data collection window. Results will also be reported by age group.
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