Swaddling to Overcome the Challenges of Peripheral Venous Access in Infants: A Pilot Study


Peripheral intravenous catheter insertion in children in the emergency room has a number of risks, and these increase while the infusion is given to infants. Health personnel attempt to cope with several difficulties in this situation. This study aimed to describe the difficulty of peripheral intravenous insertion factors as well as the interventions implemented to overcome these challenges. This study used a quantitative design with descriptive analysis. 34 nurses and four midwives participated in this study by filling out a questionnaire. According to the findings, the average respondent had four years of work experience and all respondents had infused infant patients in the emergency room in the previous two months. 44.7% of health workers identified venous characteristics of patients as a challenge and 44.1% identified active children as a challenge. Emergency room personnel use a venous viewer 50% of the time and a swaddle 44.7% of the time to overcome infusion difficulties. Due to the challenges of deep palpable veins and small veins, nurses use a vein viewer, whereas for active babies, nurses use the swaddling method.

Keywords: difficulty factors of venous insertion, swaddling, infants

[1] Arora S. Elsevier’s clinical skills manual: Child health nursing. 1st ed. New Delhi: Elsevier; 2020.

[2] Carr PJ, Rippey JCR, Cooke ML, et al. Development of a clinical prediction rule to improve peripheral intravenous cannulae first attempt success in the emergency department and reduce post insertion failure rates: The Vascular Access Decisions in the Emergency Room (VADER) study protocol. BMJ Open. 2016;6(e009196):1–7.

[3] Kementrian Kesehatan RI. Peraturan Menteri Kesehatan Republik Indonesia Nomor 26 Tahun 2019.

[4] Kuensting LL, Deboer S, Holleran R, Shultz BL, Steinmann RA, Venella J. Difficult venous access in children: Taking control. Journal of Emergency Nursing. 2009;35(5):419–24.

[5] Parker SIA, Bnezies K, Hayden K. A systematic review: Effectiveness of pediatric peripheral intravenous catheterization strategies. Journal of advanced nursing. 2016;73(3):1570–1582.

[6] Watson J. Watson’s theory of human caring and subjective living experiences: Carative factors/caritas processes as a disciplinary guide to the professional nursing practice. exto & Contexto-Enfermagem. 2008;16, 129-135.

[7] Casman, Pradana AA, Edianto, Rahman LOA. Kaleidoskop menuju seperempat abad pendidikan keperawatan di Indonesia. Jurnal Endurance: Kajian Ilmiah Problema Kesehatan. 2020;5(1):115–25.

[8] Yuningsih R, Rustina Y. Complication of peripheral IV catheterization in neonates: A systematic review. Jurnal Keperawatan Muhammadiyah. 2019;4(2):295–301.

[9] Carr PJ, Rippey JCR, Cooke ML, et al. Factors associated with peripheral intravenous cannulation first-time insertion success in the emergency department. A multicentre prospective cohort analysis of patient, clinician and product characteristics. BMJ Open. 2019;9(e022278):1–10.

[10] Yuningsih R, Rustina Y, Efendi D. The related factors of phlebitis among low birth weight infants in perinatology ward. Pediatr Reports. 2020;12(8691):12–15.

[11] Nelson AM. Risk and benefits of swaddling healthy infants: An integrative review. MCN: The American Journal of Maternal/Child Nursing. 2017;42(2).

[12] Aditya N. Handbook for mom. Yogyakarta: Stiletto Book; 2020.

[13] Erkut Z, Yildiz S. The effect of swaddling on pain, vital signs, and crying duration during heel lance in newborns. Pain Management Nursing. 2017;18(5):328–36.

[14] Karimi AA, Jahanpour F, Mirzaei K, Akeberian S. The effect of swaddling in physiological changes and severity of pain caused by blood sampling in preterm infants: Randomized clinical trial. International Journal of Pharmaceutical and Phytopharmacological Research (eIJPPR). 2019;8(5):1–5.