Improving blood gas analysis sample collection in pediatric emergency departments: a best practice implementation project

INTRODUCTION: Critically ill children in the pediatric emergency department require quick evaluation and decision-making. Blood gas analysis is a frequently conducted procedure and is used to assess respiratory failure, electrolyte disturbance, and acid-base imbalance, among others. However, inappropriate blood sample collection and processes can result in inaccurate blood gas analysis results and delay treatment. OBJECTIVE: This project aimed to improve compliance with evidence-based practices for blood gas sample collection in a pediatric emergency department. METHODS: Using the JBI Evidence Implementation Framework, this project involved three phases: baseline audits, intervention strategy implementation, and follow-up audits. Conducted at Shenzhen Children's Hospital in China, the study involved the participation of 42 nurses and 300 patients between June and December 2023. Baseline evaluations identified compliance issues and barriers, leading to targeted interventions. RESULTS: The baseline audit revealed poor compliance with evidence-based practice. Out of 12 criteria, three criteria achieved 100% compliance and four criteria exceeded 80% compliance, while the other five criteria showed ≤60% compliance. The main barriers were insufficient staff education, lack of accessible workflows, and limited motivation for evidence-based practices. After implementing evidence-based practice interventions, a follow-up audit demonstrated significant improvements across all criteria. CONCLUSIONS: Enhancing evidence-based blood gas sample collection increased nurses' compliance and highlighted potential areas for improving pediatric patient care. Future studies should evaluate sustainable methods for pain management and arterial catheterization blood collections. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A591.