Local anesthesia before intravenous cannula insertion: Recommendations for registered nurses in practice

Abstract

Objective: The purposes of this project were to educate registered nurses of the intradermal, pretreatment procedure; provide education on the hospital’s current IV therapy pretreatment policy; and increase the usage of intradermal, local anesthesia for cannulation for adult patients’ comfort level.

Methods: A mixed method of nonexperimental descriptive pre- and post-survey was used. The data was collected from 48 registered nurses’ pre- and post-surveys indicating descriptive analysis. The descriptive analysis identified barriers as to why registered nurses were not using pretreatment prior to IV insertion.  

Results: The results revealed the majority of the participants (83%) were not aware of the hospital’s IV pretreatment policy of intradermal anesthesia with Lidocaine before IV insertion prior to the DNP project. Evidence indicated inconsistency in the use of pain management strategies during these procedures. The conclusions of this project provided an important overview of the barriers to change in clinical practice for registered nurses with IV skills.

Conclusions: An improvement project educational program, such as an educational video on how to preform intradermal pretreatment to an IV site prior to IV insertion and utilization of a manikin IV arm for simulation practice, was developed and recommended to a nursing IV therapy practice for registered nurses. Local anesthetic, such as intradermal, should become standard practice for registered nurses regarding pretreatment for pain control prior to intravenous insertion.