Date of Graduation

Summer 8-15-2017

Document Type

Project/Capstone

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

First Advisor

Dr. Susan Mortell

Second Advisor

Dr. Carlee Balzaretti

Abstract

Neonatal sepsis is associated with increased mortality and morbidities including lengthy hospital stays. Neonate’s immature immune system and susceptibility to sepsis make them prone to antibiotic treatment. Lack of recommendations points to the need for evidence-based practices when selecting a vascular access device (VAD). Literature reviewed demonstrated that a midline catheter (MC) was an option for a VAD with neonatal populations requiring antibiotic therapy more than 48 hours. MCs offer fewer complications compared to the peripheral intravenous (PIV) device. The objective of this project is to reduce the amount of pain experienced by neonates by reducing the number of PIV attempts made by advocating for a MC as the appropriate VAD. The method used in this project was a retrospective chart audit. Approximately 43 babies needed antibiotic therapy and only had PIV access. The average PIV attempt was 2.5. Lewin’s Change Theory was used as the project’s framework. Educating nurses in the risks/benefits of a MC supports advocating and collaborating with physicians on the plan of care. Establishing a policy and procedure for MC criteria is needed. Patient advocacy and nurse-to-physician collaboration were evaluated with questions regarding identification and implementation of a MC in appropriate cases.

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