Running head: REVIEW OF REFERENCES: RECOGNIZING AND TREATING 1

Review of References: Recognizing and Treating IV Infiltration/Extravasation in Neonate and

Pediatric Patients
Sydonie Stock
Ferris State University

REVIEW OF REFERENCES: RECOGNIZING AND TREATING IV INFILTRATION/
EXTRAVASATION IN NEONATE AND PEDIATRIC PATIENTS 2

Abstract

As a nurse, an important skill is analyzing and critiquing Evidence-Based articles. This will help
the nurse recognize biases, limitations, or faulty research and distinguish those from the articles
that are reliable, of good quality and sound research. Though an article comes from a reputable
journal, the article itself may not be adequate for a nurses need. On the other hand, an article
could be well written, well researched, but published by a journal or site that is not reliable.
With this knowledge, the nurse can determine what research should be incorporated into the
hospital or facilitys nursing guidelines. The nurse will be able to determine best practice and
use this knowledge when caring for clients.

REVIEW OF REFERENCES: RECOGNIZING AND TREATING IV INFILTRATION/
EXTRAVASATION IN NEONATE AND PEDIATRIC PATIENTS 3

Review of References: Recognizing and Treating IV Infiltration/Extravasation in Neonate and
Pediatric Patients
As an analysis of the articles cited in a previous paper, each source will be analyzed for
its credibility, relationship to nursing research, and significance to nursing care. Ultimately they
will be judged as either an adequate, or good, source or as a poor source for the paper in which
they were originally used.
Review
There are several types of research, when finding articles for a paper or study, only
credible sources should be used. These credible, or scholarly, sources can be found in a refereed
journal or as a peer reviewed article. Rose Nieswiadomy (2012) defines a refereed journal as a
journal whose articles are reviewed by experts in that subject (p. 265). A peer review occurs
when professional colleagues review a manuscript; the peers are knowledgeable in the subject
matter, but not necessarily considered experts (Nieswiadomy, 2012, p. 265).
Two types of studies are qualitative and quantitative. A qualitative study is one in which
subjective material, feelings or experiences, are analyzed; while a quantitative study has
measurable outcomes, deals in numbers and facts, and its results can be generalized for a more
broad population (Nieswiadomy, 2012, p. 265).
Article 1
Credible source. The first article used, entitled A new approach to management of
intravenous infiltration in pediatric patients: pathophysiology, classification, and treatment
came from the Journal of Infusion Nursing (Amjad, Murphy, Nylander-Housholder, Ranft,
2011). The Journal of Infusion Nursing is a credible source. The Journal offers an online
manuscript submission for peer review (Journal of Infusion Nursing, 2013).
REVIEW OF REFERENCES: RECOGNIZING AND TREATING IV INFILTRATION/
EXTRAVASATION IN NEONATE AND PEDIATRIC PATIENTS 4

Nursing research. Although this article was set up like an experimental study, upon
deeper examination it was found to simply be a description of a proposed treatment of
infiltration. The quantitative experiment is still pending due to institutional reluctance. The
hospitals are not willing to disclose the number of infiltrations occurring at their facility and
fear the legal implications of such information becoming public (Amjad et al., 2011).
There are four authors who wrote this article and are planning to conduct the research, if
approved. They are Ibrahim Amjad, Travis Murphy, Linda Nylander-Housholder, and Amanda
Ranft. Amjad is a pediatric plastic surgeon and Murphy was, at the time the article was
published, a medical student at the University of South Florida. Nylander-Housholder and Ranft
both hold a Masters degree in Nursing and an Advanced Registered Nurse Practitioner license.
Nylander-Housholder has 20 years experience in Pediatric Intensive Care. Ranft has 10 years
experience in Neonatal Intensive Care and was, at the time the article was published, the
supervising nurse of a Neonatal Intensive Care Unit. (Amjad et al., 2011).
Significant to Nursing. The results of the future study could prove significant to nursing
and how nurses care for pediatric and neonatal patients with intravenous (IV) fluids. This
particular article, however, is not significant because there is no experiment proving the benefits
of the proposed treatment over the existing actions taken.
Borrowed knowledge is information studied and proven by another discipline but used
by nurses (Nieswiadomy, 2012, p. 5). Since nurses were part of every step - developing the
therapy, writing the article, and petitioning hospitals - this would not be considered borrowed
knowledge. This is a collaborative effort between nursing and medical staff.
Article 2
REVIEW OF REFERENCES: RECOGNIZING AND TREATING IV INFILTRATION/
EXTRAVASATION IN NEONATE AND PEDIATRIC PATIENTS 5

Credible source. The second article, Treatment of intravenous infiltration in a
neonate, came from the Journal of Pediatric Health Care. The journal is published by and is
considered the official journal of the National Association of Pediatric Nurse Practitioners.
The journal provides scholarly clinical information and research about pediatric care
(Journal of Pediatric Health Care, 2013). This is a credible source.
Nursing research. This article was not an experimental study, but a case study. In it was
discussed the history, presenting problem, assessment, and plan of a neonate suffering from IV
infiltration (Kuensting, 2010). Laura Kuensting, a registered nurse with a Masters degree in
Nursing, a Certified Pediatric Nurse Practitioner license, and a Certified Pediatric Emergency
Nurse license authored the case study.
Significant to nursing. This case study is not statistically relevant to nursing care since
it only discusses the one patient. However, it could be significant to a research study conducted
on the various treatments of IV infiltration. There are no conclusions to be gathered from the
article that can apply to more than that one patient. This article was written by a nurse and so it
is not borrowed knowledge.
Article 3
Credible source. The third article being analyzed is titled, A pediatric peripheral
intravenous infiltration assessment tool. It, like the first article, is from the Journal of Infusion
Nursing. As previously discussed, the Journal of Infusion Nursing is a credible source with peer
reviewed articles written by and for nurses (Simona, 2012; Journal of Infusion Nursing, 2013).
Nursing Research. This article was describing a prospective, observational study
where data from 102 patients, ages up to 18 years, were included. In the study, a new IV
assessment tool was developed for use in a large university-affiliated pediatric tertiary care
REVIEW OF REFERENCES: RECOGNIZING AND TREATING IV INFILTRATION/
EXTRAVASATION IN NEONATE AND PEDIATRIC PATIENTS 6

facility in the Southwest. A group of experts evaluated the assessment tool and approved its
use. The new assessment tool was implemented in the hospital with Institutional Review Board
and hospital approval. Rodica Simona is the author of this study and claims to have no
conflicting interests in performing this study. She is a Registered Nurse and has a PhD (Simona,
2012).
Significant to Nursing. The result of this study is distinct to the nursing profession
because nurses are the ones inspecting IV sites and would be the ones to notice an infiltration.
Having the appropriate measurement tool for pediatric and neonate infiltration levels is important
for correct treatment. As Simona is a Registered Nurse and used nurses in the hospital to collect
the study data, this is not borrowed knowledge.
Reflection
The original paper was written to identify different methods of assessing and treating
infiltration and extravasation in neonates and children. The paper was not looking to update or
change hospital policy, but rather to show the various options one has. For the purpose of the
original paper, I feel that all three articles were appropriate to use. All three came from credible,
peer-reviewed, Nursing Journals, were written by nurses, and each is significant to the field of
nursing in some way.
If I were looking for evidence to support changing hospital policy regarding infiltration
and extravasation in neonates and children, I would only use the third article discussed here.
Being the only study out of the three, it is the only one with data and results that lead to the
conclusion that a different measuring tool should be used for neonates and children than adult
patients with infiltration or extravasation. The other two articles did not prove best practice, and
so should not influence hospital policy.
REVIEW OF REFERENCES: RECOGNIZING AND TREATING IV INFILTRATION/
EXTRAVASATION IN NEONATE AND PEDIATRIC PATIENTS 7

In order to find evidence-based practice, a nurse needs to look at credible sources as
described previously. In order to find best practice for the field of nursing, the research should
be conducted by nurses. Who better knows what minute details to look for than a nurse? Now
that Nursing is a profession, with its own specific body of knowledge (Nieswiadomy, p. 3), we
need to perform our own research. We should not rely on other professions to find the
information we need. Borrowed information is no longer the only means for nurses to gain
knowledge; we can find our own and collaborate with other professions to expand our
knowledge base.

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References
Amjad, I., Murphy, T., Nylander-Housholder, L., & Ranft, A. (2011). A new approach to
management of intravenous infiltration in pediatric patients: pathophysiology,
classification, and treatment. Journal of Infusion Nursing, 34(4), 242-249.
doi:10.1097/NAN.0b013e31821da1b3.
Journal of Infusion Nursing. (2013).
http://journals.lww.com/journalofinfusionnursing/pages/default.aspx.
Journal of Pediatric Health Care. (2013). http://www.journals.elsevier.com/journal-of-pediatric-
health-care/.
Kuensting, L. (2010). Treatment of intravenous infiltration in a neonate. Journal of Pediatric
Healthcare, 24(3), 184-188. doi:10.1016/j.pedhc.2010.02.001.
Nieswiadomy, R. (2012). Foundations of nursing research (6
th
ed.). Upper Saddle River, NJ:
Pearson Education, Inc.
Simona, R. (2012). A pediatric peripheral intravenous infiltration assessment tool. Journal Of
Infusion Nursing, 35(4), 243-248.