• Ming-Ying Li, Chia-Wen Yu, Ya-Chun Yang, and Chun-Chu Chang.
• Department of Nursing, Linkou Chang Gung Memorial Hospital, Taiwan, ROC.
• Hu Li Za Zhi. 2014 Apr 1; 61 (2 Suppl): S68-75.

Background & ProblemsPeripheral intravenous catheter insertion is a significant source of stress for preschoolers during hospitalization. An average of about 85% of pediatric patients at our general pediatric unit are preschoolers. An average 71% of these exhibit severe pain-related behavior during intravenous insertions. The factors influencing this pain experience may include inappropriate administration of analgesics by nurses, non-pharmacologic pain management, and inappropriate clinical settings.PurposeThis project worked to develop a strategy to reduce the incidence of severe injection pain in preschool children from 71.0% to 36.0% and to achieve a capacity improvement target of 50%.ResolutionsWe implemented the following: 1) arranged a relevant training program for pediatric nurses; 2) revised hospital standards for pediatric intravenous insertions; and 3) enhanced analgesic administration and non-pharmacologic pain management through creating child-friendly clinical settings and providing interactive toys.ResultsAfter implementing the above mentioned interventions, the incidence of severe pain-related behavior in pediatric patients decreased from 71.0% to 19.7%, a result that greatly exceeded expectations.ConclusionsThis project demonstrated an effective approach to reducing severe intravenous-insertion pain in preschoolers and increasing pediatric care quality.

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