Volume 7, Issue 1, January – 2022 International Journal of Innovative Science and Research Technology

ISSN No:-2456-2165

Knowledge and Practice of Nurses Towards

Peripheral Intravenous Cannulation in Pediatric
Patients in Selected Public Hospitals Khartoum –
Sudan
Selwa Y Abdeldafie
Assistant Professor Nursing Department/ University of Hafr Albatin /KSA

Abstract:- Placing an intravenous cannula for children is assessment of the vein, skin and general look of the child is
one of the nurse’s role in emergency, intensive care unit important prior to the procedure. (2)
or wards. It can be performed for diagnostic, nutritional
or therapeutic reasons. In spite of the development and technology in healthcare
including intravenous therapy but still morbidities like
The overall aim of this study was to assess nurses’ phlebitis is the most occurring complication. (3)
knowledge and practice towards peripheral intravenous
cannulation in pediatric patients. An interventional Due to its invasive nature, transmitting infection may
hospital-based study design, quantitative approach was result and morbidity and mortality among vulnerable children
selected for this work. The study was conducted in two such as neonates or low immune children are expected to
main public hospitals in Khartoum. The study population increase so increasing the level of knowledge and skills of
were Nurses of all categories who worked in the study nurses is recommended. (4).
area during the study period of data collection (60 nurses).
Data collection techniques used are interviewing and  Objective
observing. Tools used to collect data are questionnaire The overall aim of this study was to assess the level of
and observational check list. Data was processed and nurses’ knowledge and practice towards peripheral
analyzed by computer program which is SPSS Ver.19.0 intravenous cannulation in pediatric patients.
The study showed a significant relationship between the
educational program and the change in the level of II. METHODOLOGY
knowledge for nurses who participated in the study as the
P.value found to be 0.00 and also significant change in the  Study design
practice. So the study concluded that: Nurses are This is an interventional hospital-based study aiming to
motivated to learn as evidenced by the change in their assess the effect of educational program on nurses’
knowledge and practice after implementing the knowledge and practice towards peripheral intravenous
educational program. cannulation in pediatric patients.

Keywords:- Intravenous Cannula; Peripheral Intravenous  Study setting

Cannulation; Pediatric. The current study was conducted in two public hospitals
that provide pediatric health care. Those hospitals are Ibrahim
I. INTRODUCTION Malik Hospital and Turkey hospital. Both of them are
sponsored by state ministry of health.
An intravenous peripheral cannula is considered as one
of the important procedures done in either emergency room  Turkey hospital
or in the wards and pediatric units to give medications, It is located in Alkalakla- Khartoum providing care for
intravenous fluids, blood or blood products, taking blood all age groups with all medical specialties. The pediatric
samples for investigation or for nutritional purposes. Hence, department consists of: emergency room and general wards
nurses’ knowledge and practice are crucial regarding this or long stay rooms. Emergency room capacity is 40 beds.
procedure. Since the patient skin is going to be penetrated for
the insertion purpose, the intravenous cannula insertion has  Ibrahim Malik teaching hospital
been considered as an invasive procedure that requires a It lies in Alsahafa _Khartoum , providing acre for all age
thorough nursing care and attention to prevent complications groups with various medical and surgical conditions. The
(1) pediatric ward capacity is 60 beds.

The youngest the child’s age, the more need for a skillful  Study population
professional for cannulation to eliminate or reduce the risk of The target population of the study were all BScs, MScs,
multi trials due to extremities movement, so a comprehensive diploma nurses who worked in emergency department during
the period of data collection (60 nurses).

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Volume 7, Issue 1, January – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
The sampling technique and sample size: P value by using Chi-square and performing statistical
significance analysis to test the impact of the intervention on
The sample was drawn from the population by the equation: the knowledge and practice of nurses towards the insertion of
n=z2 pq / e2 intravenous cannulation in pediatric patients.
Where:
n=sample size  The ethical approval:
z=1.96 The study proposal was sent for the hospital managers
p=prevalence of the procedure under study =0.5 and it was officially endorsed by the ethical committee in the
q=1-p=0.5 (5) Hospitals where the study was conducted.

The calculated sample size was equal to 384 but the collected Any participant was informed about the aims of study,
data obtained from ( 60 ) participants using consecutive none the right to participate /withdraw and his/her role as a
probability sampling technique. participant, and then a verbal consent was taken.

 Data collection tools and techniques: III. THE RESULTS AND DISCUSSION
Data about nurses’knowleddge was collected by
interviewing technique using self-administered questionnaire The current study about nurses’knowleddge and
while the nurses practice was assessed by observational practice towards peripheral intravenous cannulation in
checklist during performing the procedure under study. pediatric patients was conducted in two public hospital
Khartoum –Sudan.
The questionnaire composed of three sections:
 Frist sections contains the demographic data of the study Majority of participants in both groups were female
participants. 51(85 %) this result is similar to (6) and inconsistent with (1)
 The second section contains data of knowledge about the whose findings revealed 37(61.7%) of the participants are
indications or purposes of insertion and the pre-procedural male.
care.
 The third section contains data of knowledge regarding Regarding level of education, it is found to be (in both
intra and post-procedural care of patients. groups) 8, 48 and 4 for Diploma, Bsc and Msc. respectively.
Regarding receiving training courses, the current study
 Phases of the study: revealed that 24 (40%) didn’t receive training courses,
The study consisted of the following three consecutive 30(50%) nurses received training courses inside the country
phases: while only 6(10%) nurses were trained outside the country in
both groups. Nurses’ knowledge regarding indications for
 Pre-intervention phase: peripheral intravenous cannulation in pediatric patients are
A written consent from the hospitals managers was significantly changed in the intervention group post
obtained to carry out the study. The data collection tools educational program as expressed by the P.value equal to
(questionnaire, checklist and the educational program) were 0.002 on the other hand, no significant change in the control
designed including all variables to assess the peripheral group as evidenced by the P.value equal to 0.066.
intravenous cannulation. The research team includes the
researcher and two other researcher assistants who were Selecting the suitable cannula size for the pediatric
selected and trained for the purpose of data collection. patient is an important issue in peripheral intravenous
cannulation, the current study showed significant change in
 Interventional phase: nurses’knowleddge pre-and post-educational program with
The interventional phase includes the pre-assessment P.Value equal to 0.00 in the intervention group, this result
and conduction of educational program. So each research was consistent with (7)
team member was assigned to teach a group of 3-4 nurses in
the interventional group the standard knowledge and practice Peripheral intravenous cannula must be removed after
towards peripheral intravenous cannulation. 72 hours or less, the current study reported this good practice
among the intervention group, this finding agreed with (7)
 Evaluation phase:
The post-assessment questionnaire was conducted for both Nurses were knowledgeable regarding indications and
interventional and control groups to assess the impact of the purposes of peripheral intravenous cannulation, preparing
educational program nurses’ knowledge and practice towards equipment, appropriate selection of a vein and suitable size of
peripheral intravenous cannulation. cannula for peripheral intravenous cannulation, removal or
changing cannula after 12-72hours, possible complication of
 The data processing and analysis: peripheral intravenous cannulation and documentation of the
Data were analyzed using the Statistical Packages for procedure. Moreover, they reflected good level of practice in
Social Sciences (SPSS). Results were presented in the form the intervention group post-educational program.
of simple frequency tables, graphs and cross tabulation to
calculate.

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Volume 7, Issue 1, January – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
IV. CONCLUSION Indian Journal of Forensic Medicine &
Toxicology,2021 Vol. 15, No. 3
The current study concluded that nurses were motivated [2]. Büyükyılmaz F etal.: Effectiveness of an Intravenous
to learn so that their level of knowledge changed markedly Protection Device in Pediatric Patients on Catheter
post-intervention in the intervention group. The educational Dwell Time and Phlebitis Score. Asian Nursing
program achieved the desirable effects on nurses’ knowledge Research.13(2019) 236-241
and practice. [3]. Uma T , Mayengbam BD and AnthonyM: Effectiveness
of intermittent normal saline flushing in maintaining the
RECOMMENDATIONS patency of intravenous cannula. Manipal Journal of
Nursing and Health Sciences,Vol. 2 (2016) > Iss. 1
The current study recommended conduction of training [4]. Singh M and Sood A: Effectiveness of Video Assisted
programs for nurses in order to improve their knowledge and Teaching Regarding Knowledge and Practice of Intra-
skills. Conducting studies in a large group of nurses involving Venous Cannulation for Under-five Children. IOSR
more hospitals may give an accurate result that can be Journal of Nursing and Health Science (IOSR-JNHS)
generalized. Volume 5, Issue 5 Ver. VII (2016), PP 10-15
www.iosrjournals.org
ACKNOWLEDGEMENT [5]. Pourhoseingholi, MA, Vahedi, M and Rahimzadeh M
: Sample size calculation in medical studies.
Special acknowledgement to Ms. Roa Tajeldin .The Gastroenterol Hepatol Bed Bench. 2013 Winter; 6(1):
researcher would like to acknowledge the research assistants 14–17.
for their interest and hard work to achieve their duties. Also [6]. Boraste SV: Knowledge, Attitude and Practices about
would like to acknowledge the study participants for their Peripheral Venous Catheter among Junior Residents and
participation. Nursing Staff: A Cross Sectional Study. Scholars
Journal of Applied Medical Sciences (SJAMS) 2018
REFERENCES DOI: 10.21276/sjams.2018.6.8.18
[7]. Osti Ch etal: Knowledge and practice towards care and
[1]. Ali HA and Saud TA : Assessment of Nurses’ maintenance of peripheral intravenous cannula among
Knowledge towards Infections of Peripheral nurses in Chitwan Medical College Teaching Hospital,
Intravenous Cannula in Al-Basrah Teaching Hospital. Nepal.( 2019 ) WILY Nursing Open DOI:
10.1002/nop2.288

40 36
30
30
24
21
20

10 6
3
0
male female total

control intervention

Fig(1): Gender distribution among Nurses in both intervention and control groups(n=60)

30 28

25
20
20
15
10
4 4 4
5
0
0
Diploma Bsc Msc

control intervention

Fig(2): Level of Education among Nurses in Both Intervention and Control Groups(n=60)

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Volume 7, Issue 1, January – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165

Chart Title
35
30
25 9

20
15
15
10 21

5 0
9
6
0
Didn'nt receive trainning received training inside Received trainning outside

intervention Control

Fig(3): Receiving Training Courses among Nurses in Both Intervention and Control Groups(n=60)

Table (1) The nurses’ Knowledge regarding indications and purposes of peripheral intravenous cannulation in pediatric patients
(interventional & control) (n=60):
Intervention group Control group
Pre- Post- Pre- Post-
No % No % No % No %
Know 16 44.4% 33 91.9% 8 33.6% 10 41.6%
Not Know 20 55.6% 3 8.1% 16 66.6% 14 58.4%
Total 36 100% 36 100% 24 100% 24 100%
Intervention Group: Chi- square = 22.345 P.value = 0.002
Control Group: Chi- square = 8.231 P.value = 0.066

Table (2) The nurses’ Knowledge regarding suitable size of cannula for peripheral intravenous cannulation in pediatric
patients (interventional & control) (n=60):
Intervention group Control group
Pre- Post- Pre- Post-
No % N % No % N %
Know 4 11.1% 28 77.7% 4 16.6% 5 20.8%
Not Know 32 88.8% 8 22.2% 20 83.3% 19 79.1
Total 36 100% 36 100% 24 100% 24 100%
Intervention Group: Chi- square = 36.345 P. value = 0.000
Control Group: Chi- square = Chi- square = 7.231 P. value = 0.056

Table (3) The nurses’ Knowledge regarding appropriate selection of vein for cannula for peripheral intravenous
cannulation in pediatric patients (interventional & control) (n=60):
Intervention group Control group
Pre- Post- Pre- Post-
No % N % No % N %
Know 11 30.5% 28 77.7% 8 33.3% 8 33.3%
Not Know 25 69.4% 8 22.2% 16 66.6% 16 66.6%
Total 36 100% 36 100% 24 100% 24 100%
Intervention Group: Chi- square = 22.231 P. value = 0.001
Control Group: Chi- square = 6.470 P. value = 0.085

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Volume 7, Issue 1, January – 2022 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
Table (4) The nurses’ Knowledge regarding appropriate selection of vein for cannula for peripheral intravenous
cannulation in pediatric patients (interventional & control) (n=60):
Intervention group Control group
Pre- Post- Pre- Post-
No % N % No % N %
Know 20 55.5% 30 83.3% 15 62.5% 16 66.6%
Not Know 16 44.4% 6 16.6% 9 37.5% 8 33.3%
Total 36 100% 36 100% 24 100% 24 100%
Intervention Group: Chi- square = 28.425 P. value = 0.00
Control Group: Chi- square = 6.831 P. value = 0.069

Table (5) The nurses’ Knowledge regarding preparation of the patient environment and vein for peripheral intravenous
cannulation in pediatric patients (interventional & control) (n=60):
Intervention group Control group
Pre- Post- Pre- Post-
No % N % No % N %
Know 13 36.1% 32 88.8% 8 33..3% 7 29.1.6%
Not Know 23 63.8% 4 11.1% 16 66.6% 17 70.8%
Total 36 100% 36 100% 24 100% 24 100%
Intervention Group: Chi- square = 22.351 P. value = 0.002
Control Group: Chi- square = 5.232 P. value = 0.078

Table (6) The nurses’ Knowledge regarding possible complications of peripheral intravenous cannulation in pediatric
patients (interventional & control) (n=60):
Intervention group Control group
Pre- Post- Pre- Post-
No % N % No % N %
Know 9 25.0% 30 83.3% 5 20.8% 6 25%
Not Know 18 75.0% 6 16.6% 19 79.16% 18 75%
Total 36 100% 36 100% 24 100% 24 100%
Intervention Group: Chi- square = 27.391 P. value = 0.001
Control Group: Chi- square = 8.242 P. value = 0.095

The nurses ’practice in peripheral intravenous cannulation (n=60)

Intervention group(36) Control group(24)
Pre- Post- Pre- Post-
Yes No Yes No Yes No Yes No
24 12 0 6
washing hands 36 100% 18 75% 19 79.1% 5 20.8%
66.6% 33.3% 0.0% 25%
Assessing patients pre 35 12
18 50% 18 50% 1 2.7% 12 50% 12 50% 12 50%
procedure 97.2% 50%
0 14
Preparing equipment 9 25% 27 75% 36 100% 11 45.8% 13 54.1% 10 41.6%
0.0% 58.3%
10 10 14
Selecting vein 26 72.2% 34 94.4% 2 5.5% 12 50% 12 50%
27.7% 41.6% 58.3%
7 29 19
Wearing gloves 36 100% 0 0.0% 4 16.6% 20 83.3% 5 20.8%
19.4% 80.5% 79.1%
11 25 35 1 19 10 14
Practicing Sterile technique 5 20.8%
30.5% 69.4% 97.2% 2.7% 79.1% 41.6% 58.3%
Changing/ removing 13 35 16 11
23 63.8% 1 2.7% 8 33.3% 13 54.1%
cannula 12-72hours 36.1% 97.2% 66.6% 45.8%
Assessing patients post 16 0
20 55.5 36 100% 12 50% 12 50% 12 50% 12 50%
procedure 44.4% 0.0%
8 0 11 13 15
Documentation 28 77.7% 36 100% 9 37.5%
22.2% 0.0% 45.8% 54.1% 62.5%

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