Factors associated with cannula failure in paediatric patients in Malawi: an observational study

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Date
2022-04-11
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Kamuzu University of Health Sciences
Abstract
EXECUTIVE SUMMARY Background Peripheral Intravenous Cannulas (PIVC) are used in the delivery of medications, blood and blood products and fluids for resuscitation to achieve homeostasis in the paediatric setting in Malawi. Success in the placement and securement of PIVCs along with the type of treatments administered in inpatient care plays an important role in cannula failure rates. High failure rates can predispose children to cannula-related infections and other associated complications. The Type of Research Study This study will be an observational study conducted in Children Ward A, Children Ward B, Children Ward C, the Emergency Department and the Outpatient Paediatric Department in Kamuzu Central Hospital (KCH). The Problem [to be studied] In Malawi, there is no data that describes PIVC success and failure rates. This study seeks to describe the gap in the literature about the PIVC first time insertion success rates, the current practice of securement and dressing of PIVCs, and to ascertain the duration and failure of these devices in paediatric acute care at KCH. Main Objectives The main objective is to evaluate the lifespan of the PIVCs and identify the factors which affect the lifespan of PIVCs in paediatric patients at KCH. Specifically, the study will seek to: 1. To determine the risk factors for cannula failure in paediatric inpatients at KCH 2. To ascertain the reasons for cannula removal and evaluate the lifespan of a cannula in paediatric inpatients at KCH 3. To describe the incidence rates of cannula-related infections and associated complications as a result of periphery intravenous cannulation in paediatric inpatients at KCH 11-Apr-2022 11 Methodology The study will utilize a mixed-methods design involving prospective cohort study design with cross-sectional sampling methods. The population of choice will be all the paediatric patients needing first time cannulation and health personnel cannulating patients in KCH paediatric wards and the outpatient department. Both paediatric participants and health personnel will be recruited based on inclusion and exclusion criteria. The data will be collected by structured observational checklists and questionnaires. Post-cannulation, there will also be continuous follow up and supervision throughout the data collection period. Data will be analysed using EPI-INFO or SPSS. The study period for this research is 6 weeks, in which we shall collect data, analyse it and write a report Ethical Considerations Informed consent, confidentiality, non-maleficence, beneficence, and the right to voluntarily participate or withdraw from the study will be granted to the study participants in order to achieve ethical validity. The proposal will also be submitted to COMREC for approval. Permission to conduct our research at KCH shall also be sought from the hospital director. Expected Findings and their dissemination The expected findings for this study are that PIVC failure rates will be high and these rates will differ in neonates, infants and children. These results shall be presented during the Kamuzu University of Health Sciences 4th year research dissemination which invites all academic staff and members of the University, as well as, undergraduate research coordinator, The College of Medicine Research and Ethics Committee, Kamuzu University of Health Sciences Library, Head of Department of Paediatrics at KCH and the study supervisors
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