KICK It in the Pedi ED

Massachusetts General Hospital (Boston, Massachusetts)

CSI Summary

Available only to registered users.

CSI Presentation

Available only to registered users.

CSI Toolkit

Available only to users with a paid AACN membership.

Added to Collection

Project Topic

Pediatric Emergency nursing orientation

Hospital Unit

Pediatric Emergency Department

CSI Participants

Paige Fox, BSN, RN, CPEN
Susan Warchal, BSN, RN

Project Goals/Objectives

  1. To improve primary pediatric preceptors’ competence to teach IV placement in 0- to 3-year-olds 75%
  2. To improve orientees’ competence for IV placement in 0- to 3-year-olds75%
  3. To increase number of IVs placed with a corresponding order to 90%
  4. To increase the first attempt IV start success rate of orientees in 0- to 3-year-olds to 50%

Project Outcomes

  1. Improved the primary pediatric preceptors’ Likert scores in response to the question: “Please rate how you feel about the following statement: ‘I am skilled in teaching IV insertion for 0- to 3-year old patients’” from 47.2% to 100% responding “agree” or “strongly agree”
  2. Increased IVs placed with corresponding order from 54% to 77%
  3. Increased IV start success on first attempt from 49% to 55%
  4. These outcomes resulted in an estimated annual fiscal impact of $2,738.

Project Overview

Our Pediatric Emergency Department orientation process was inconsistent and often incomplete. New nurses shared feedback that they felt uncomfortable about caring for pediatric patients, specifically when performing procedures such as IV placement in young children.

We reviewed adult learning principles and best practices around IV placement, and created a new curriculum for IV placement in 0- to 3-year-old patients. We then identified a group of primary preceptors and taught them the curriculum, so they could in turn teach their orientees in a comprehensive and consistent manner.

Several months after implementing this teaching method, we are excited to see that our preceptors feel more comfortable teaching IV starts in 0- to 3-year olds. We also noticed that new nurses in pediatrics felt more prepared to care for pediatric patients in general, and that communication improved with the providers regarding IV placement and IV orders.

We are in the process of creating a teaching module about straight catheter placement in 0- to 3-year-olds, and then plan to create a bundle of modules for preceptors to use in standardizing the orientation process for all orientees in the Pediatric Emergency Room.

Permission to Reuse Materials
The materials associated with this AACN Clinical Scene Investigator (CSI) Academy project are the property of the participating hospital noted above, not AACN. Requests to use content contained in the CSI team’s summary, presentation or toolkit should be directed to the hospital. We suggest reaching out to the hospital’s Communications, Marketing or Nursing Education department for assistance.

The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.