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abstract
Venipunctures are very distressing for children. Nurses who routinely perform venipuncture procedures report an interest in becoming proficient in this skill. This procedure includes monitoring for potential adverse outcomes and providing age-appropriate coping strategies. These interventions make this necessary experience more positive. This study evaluated whether the completion of an evidence-based online tutorial program improved knowledge, attitudes, and self-reported venipuncture practices. Pre- and postintervention self-assessment data were obtained from 426 nurses who provide direct patient care in medical-surgical units and clinics at a pediatric Magnet hospital. Analyses of these data determined that nurses improved their ability to grade intravenous infiltrates (t = 155.78, df = 1, p = .000) and phlebitis (t = 172.14, df = 1, p = .000). These results showed that an online training program increases knowledge and practices regarding venipuncture.
J Contin Educ Nurs 2010;41(4):179-185.
Providing care to children includes the necessity of performing painful procedures, especially when needles are involved. Venipuncture is used to obtain blood samples or to place an intravenous (IV) catheter. This procedure has been reported to be a moderately to severely distressing experience for more than 50% of children (Fradet, McGrath, Kay, Adams, & Luke, 1990; Humphrey, Boon, Linden van den Heuvell, & van de Wiel, 1992). Research by Caty, Ritchie, and Ellerton (1989) determined that parents rate needle procedures as the second most distressing event during hospitalization, second only to waiting for their child during surgery. Broome (1990) postulated that when a child is unable to understand the reasons for venipuncture, it can be a terrifying experience, with long-lasting psychological implications. Previous research determined that children younger than 7 years express more distress before and during venipuncture than older children (Fradet et al., 1990; Humphrey et al., 1992; Lander & Fowler-Kerry, 1991). Research also showed that ineffective parental coping may be a factor that negatively influences behavior during procedures (Blount, Landolf-Fritsche, Powers, & Sturges, 1991; Kolk, van Hoof, & Dop, 2000; Naber, Halsted, Broome, & Rehwaldt, 1995).
Nurses and other health care providers should actively assist children to cope during the venipuncture procedure because this will reduce potential adverse effects (Willock, Richardson, Brazier, Powell, & Mitchell, 2004). Research by MacLaren and Cohen (2005) randomly provided children undergoing venipuncture with one of three interventions:...