Reducing Pain With IV Insertion Using a Needleless Anesthetic Device in the Pediatric Ambulatory Surgery Unit.

Abstract

Purpose: To reduce pain scores with intravenous (IV) insertion by 50% over 2 months among children in the ambulatory surgery center within a pediatric academic hospital.

Design: Evidence-based quality improvement project.

Methods: The project was implemented on a pediatric ambulatory surgery unit within a large, urban pediatric academic hospital. Interventions included implementing an evidence-based needleless anesthetic (J-Tip) with 1% buffered lidocaine. The team collected baseline data based on the standard unit practice before implementation. Our primary outcome was the mean pain scores during IV insertions for children receiving a peripheral IV for ambulatory surgery, and our secondary outcomes were pain scores with the application of the anesthetics and the number of IV attempts. This was carried out through practice changes implemented in Plan-Do-Study-Act (PDSA) cycles.

Findings: Mean pain scores decreased by 72%. This was a statistically significant improvement (P < .05) from baseline (x̄ = 5.3) to post intervention (x̄ = 1.5). We found a slight decrease in IV attempts in the intervention group, from 1.47 to 1.35.

Conclusions: This quality improvement project significantly enhanced the quality of care for pediatric patients in the ambulatory surgery unit by effectively decreasing pain associated with IV insertions. By implementing evidence-based strategies such as needleless anesthetic devices, perianesthesia nurses can minimize pain and create a less intimidating environment for pediatric patients.