Nursing interventions to improve peripheral intravenous catheter outcomes in pediatric patients: a systematic review and meta-analysis

Abstract

Nursing interventions related to peripheral intravenous catheters help reduce the risks of catheter-related clinical outcomes. This study aims to evaluate the effectiveness of nursing interventions aimed at improving peripheral intravenous catheter outcomes in pediatric patients. Methods A comprehensive search was conducted in CINAHL, PubMed, Scopus, Embase, MEDLINE, PsycINFO, and the Cochrane Library for studies published between 2000 and 2025. Nursing interventions included those targeting infiltration, extravasation, catheter failure, and dwell time in hospitalized pediatric patients aged 0–18. Thirteen studies were qualitatively reviewed. Seven RCTs were meta-analyzed. Data analysis used CMA v3 to calculate Hedges' g under a random effects model. Results The systematic review findings show that nursing-based interventions have generally reduced infiltration and catheter failure rates, prolonged catheter dwell time, and improved quality of care. The pooled effect size for catheter dwell time was small and non-significant. Due to high heterogeneity, a subgroup analysis was performed, revealing that catheter duration was significantly prolonged in studies including the pediatric population, but no significant effect was observed in neonatal studies. Conclusion Nursing-based interventions, particularly fixation methods and evidence-based care packages, can improve peripheral intravenous catheter outcomes in pediatric patients. However, heterogeneity between studies, methodological limitations, and differences in outcome definitions highlight the need for separate, standardized protocols and large-scale, multicenter RCTs for pediatric and neonatal IV management. Implications for practice Demonstrating the potential of nursing-based interventions to improve peripheral IV catheter outcomes in pediatric patients, this contributes significantly to the development of standardized care protocols in clinical practice.