Abstract
Objective:to elaborate and validate the content and appearance of an algorithm for treating infiltration and extravasation of non-chemotherapy drugs and solutions administered to children.Method:a methodological study of the technology formulation and validation type. To elaborate the algorithm, a bibliographic review was carried out to list the scientific evidence on the treatment of infiltration and extravasation. Content and appearance validation was in charge of 14 specialists in pediatric nursing, using the Delphi technique, adopting a value equal to or greater than 0.80 as Content Validation Index.Results:the algorithm was validated in the third evaluation by the judges, reaching a Global Content Validation Index of 0.99, being composed by the perception of the occurrence of the complication; discontinuation of intravenous therapy infusion; verification of signs and symptoms; measurement of edema; application of an infiltration and extravasation assessment scale and conduits to be used according to the characteristics of the fluid administered and the type of complication.Conclusion:the algorithm was validated and can be used in a practical and objective way by health professionals, in order to promote safety in the care of hospitalized children, with regard to reducing harms caused by infiltration and extravasation.
Highlights
Peripheral intravenous catheterization is an invasive procedure and is commonly performed in pediatric units[1] for the administration of drugs, solutions, nutrients and blood products
The algorithm entitled “Algorithm for treating peripheral intravenous infiltration and extravasation of non-chemotherapeutic drugs and solutions administered to children” displays the following sequence of information provision: perception of the occurrence of the complication, discontinuation of the intravenous therapy infusion, verification of signs and symptoms, measurement of edema, application of an infiltration and extravasation assessment scale and conducts to be used according to the characteristic of the fluid administered and type of complication
After the process of elaborating the algorithm, it was submitted to the evaluation of a group of specialists composed of 14 professionals, all of whom are nurses, female (92.9%), with PhD academic degrees (35.7%) and who work in their greatest proportion in the field of teaching and research (35.7%)
Summary
Peripheral intravenous catheterization is an invasive procedure and is commonly performed in pediatric units[1] for the administration of drugs, solutions, nutrients and blood products. Many of these fluids can cause local complications associated with intravenous therapy (IVT), defined as adverse events that cause signs and symptoms around the catheter insertion site[2]. In the aforementioned research, carried out in Brazil, the following risk factors for complications associated with the use of peripheral IVT were identified: history of complications, prolonged use of this therapy, mainly non-irritating/vesicant drugs and vesicant solutions[4]. A number of research studies show that infiltration is more frequent in children receiving medications such as 10% glucose, ampicillin/sulbactam, vancomycin, high-concentration electrolytes and phenytoin[6] and that acyclovir, antibiotics, norepinephrine, dopamine, sodium bicarbonate, sodium chloride, calcium gluconate, propofol, contrast, blood and total parenteral nutrition[7] cause more extravasation
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