Testing the Effectiveness of a New Device to Prevent Medical Line Entanglement in Pediatric Patients

Tuesday, 19 November 2013: 8:30 AM

Heather Janiszewski Goodin, PhD, RN
Department of Nursing, Capital University, Columbus, OH
Nancy Ryan-Wenger, PhD, RN, FAAN
Nationwide Children's Hospital, Columbus, OH
Joyce Mullet, RN
Nursing, Nationwide Children's Hospital, Columbus, OH
Pamela Creech, BSN, RN, CPN
Inpatient General Medicine Unit (H9A), Nationwide Children's Hospital, Columbus, OH

Learning Objective 1: Describe the safety and effectiveness of the Medical Line (ML) Wrap in the prevention of medical line entanglement among pediatric patients.

Learning Objective 2: Discuss the importance of implementing the ML Wrap into clinical practice to help protect children from medical line entanglement adverse events during hospitalization.

Purpose: Globally, unintentional injuries are the leading cause of death in children.1 In hospitalized children, unintentional injuries from medical line (ML) entanglements occur when lines become tangled, compressed, or looped around patients’ necks or other body parts.2 The purpose of the study was to test the safety and effectiveness of a new medical device invented by a nurse called the ML Wrap, designed to prevent line entanglements in pediatric patients. The ML Wrap can be placed on intravenous lines, feeding tubes, oxygen tubes, and monitor cords to prevent patient harm such as strangulation, impaired circulation, tubing dislodgment, and misidentification of lines. The study was based on the Medical Line Safety Model that includes human, system, and medical line factors that contribute to level of harm from entanglements.2

Methods: A randomized, longitudinal, controlled design was used to measure the frequency and severity of medical line entanglements in a usual care group (n = 124) compared to the intervention group (n = 124) with the ML Wrap(s) in place. Hospitalized children ages 2 months to 6 years in a large pediatric hospital were observed hourly using an online data management system. Variables such as demographics, patient activity, type of medical lines, evidence of entanglements, and Level of Harm measured by the ML Entanglement Severity Scale were collected. Chi-square analyses were used to compare groups.

Results: Compared to the control group, patients who had ML Wrap(s) on their medical lines had a significantly fewer entanglements (15.1% vs 39.9%, p<.0001) and significantly lower entanglement severity scores for intravenous lines (p<.0001), pulse oximetry (p<.0001), and oxygen (p=.017).   

Conclusion: The ML Wrap was effective in in preventing lines from getting tangled or wrapped around patients’ bodies. Use of the ML Wrap in nursing practice will promote pediatric patient safety and avoid potential harm from medical lines.