Scroll for a finished NUR 400 Module 2 Milestone One introducing a quality improvement initiative on pediatric IV infiltration, with organizational context, a data table, the problem's significance, the proposed initiative and references. Searches like "nur 400 module 2 assignment", "nur400 module 2 milestone one" and "nur 400 module 2 example" land here.
The NUR 400 Module 2 example, in full
Milestone One: Reducing Peripheral IV Infiltrations in Hospitalized Children on a Pediatric Medical-Surgical Unit
[Student Name]
Southern New Hampshire University
NUR 400: Systems Leadership for Continuous Quality
Final Project Milestone One
[Instructor Name]
[Date]
The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.
Milestone One: Reducing Peripheral IV Infiltrations in Hospitalized Children on a Pediatric Medical-Surgical Unit
Organization and Setting
Riverside Children's Pavilion is a composite 60-bed pediatric wing within a 320-bed community teaching hospital. Its mission statement commits the organization to safe, family-centered care, and its annual quality plan lists harm prevention as a top priority. The 24-bed pediatric medical-surgical unit cares for children from infancy through age 17 with conditions such as dehydration, pneumonia, appendicitis, cellulitis and complications of chronic illness. Most children receive intravenous fluids or medications through a peripheral intravenous catheter during their stay. The unit is staffed by registered nurses at a ratio of about one to four during the day, with a clinical nurse specialist shared across the pediatric wing.
The Problem
An infiltration occurs when intravenous fluid or medication leaks from the vein into the surrounding tissue. In children, whose veins are small and who may not be able to report pain or swelling, infiltrations can progress quickly. Most are mild, but severe infiltrations can cause skin blistering, tissue damage, compartment syndrome and scarring, particularly with irritating fluids or medications.
The unit's clinical nurse specialist reviewed incident reports and catheter documentation for a six-month period. The results are summarized in Table 1.
Table 1
Peripheral IV Infiltration Data for the Pediatric Medical-Surgical Unit, Six-Month Review
| Measure | Six-month value |
|---|---|
| Peripheral IV catheters placed | 1,480 |
| Catheter-days | 4,200 |
| Infiltrations documented | 118 |
| Infiltrations per 1,000 catheter-days | 28.1 |
| Infiltrations graded moderate or severe | 14 of 118 (11.9 percent) |
| Infiltrations with a skin injury requiring wound care | 5 |
| Documented hourly site checks during infusions | 58 percent of sampled hours |
Note. Composite values written for this paper.
Current Practice on the Unit
Current practice varies from nurse to nurse. The unit policy says that infusion sites should be assessed regularly, but it does not define how often, what to look for, or how to grade what is found. Some nurses check the site at every vital sign interval, others only when an infusion pump alarms, and pump alarms often do not sound during early infiltration because pressure changes are small in children. Catheters are commonly secured with opaque tape and an arm board wrapped in gauze to keep young children from pulling the line out, which protects the catheter but hides the skin around it. When an infiltration is found, nurses describe it in free text, using words such as puffy, mild or bad, which makes severity hard to compare across shifts.
Parents are often the first to notice a problem. In several incident reports, a parent reported swelling or coolness in the hand before any documented site check. Parents are not currently taught what to look for or told that they are welcome to call the nurse about the IV site at any time.
Why It Matters
The data show that infiltrations are common on the unit and that some cause real harm. A retrospective study of hospitalized children found that infiltration was associated with factors such as younger age, the site of the catheter and the type of infusion, and that risk increased with catheter dwell time, which suggests that careful monitoring and timely removal are central to prevention (Park et al., 2016). Professional infusion standards call for regular assessment of the catheter site, with more frequent checks for children and for patients who cannot report symptoms, and for prompt action when signs of infiltration appear (Gorski et al., 2021).
Beyond physical harm, infiltrations affect children and families. Each one usually means removing the catheter and placing a new one, which for a small child may take several painful attempts. Parents often describe distress and a loss of trust when they discover swelling that staff had not noticed. There are also costs: additional catheter placements, nursing time, wound care, and occasionally consultation or longer stays. The unit's own data show that only 58 percent of sampled infusion hours had a documented site check, which suggests that the problem is partly one of consistent practice rather than of knowledge alone.
The Proposed Initiative
The proposed initiative is to reduce peripheral IV infiltrations on the pediatric medical-surgical unit by 30 percent within six months through a standardized hourly site check using a validated pediatric infiltration assessment tool, a consistent securement method that leaves the insertion site visible, and involvement of parents as partners in watching the site. A validated grading tool gives nurses a shared language for severity and triggers clear actions at each grade (Pop, 2012). Visible securement allows nurses and parents to see swelling or color changes early. Parent partnership recognizes that families are at the bedside more than any staff member and can alert nurses to changes between checks.
The initiative fits the organization's mission of safe, family-centered care, requires modest resources, and can be measured with the same data used in the baseline review.
Stakeholders
Several groups have a stake in the initiative. Children and their parents are most directly affected. Staff nurses would change how they check and secure catheters, and night-shift nurses in particular will need to balance hourly checks with the goal of letting children sleep. Vascular access nurses, who place difficult catheters and are called when infiltrations occur, can help choose securement products and teach the grading tool. Pediatric hospitalists and surgeons order fluids and medications and need to know about the new grading and escalation steps. The quality department will support data collection, and the hospital's patient and family advisory council can review parent education materials to make sure they are clear and welcoming.
Leadership Responsibilities
Leading this initiative will require the nurse manager and clinical nurse specialist to secure support from pediatric hospitalists, vascular access nurses and the hospital's quality department; to protect time for staff education; and to model the practice change on every shift. The leader will also need to ensure that audits are used for learning rather than blame, so that nurses report infiltrations honestly and the data remain reliable. Milestone Two will examine leadership styles and a change theory suited to this initiative, and later milestones will develop the implementation and evaluation plan.
Conclusion
Peripheral IV infiltrations occur at a rate of 28.1 per 1,000 catheter-days on the unit, with about one in eight classified as moderate or severe and several resulting in skin injury. Evidence and professional standards point to consistent site assessment and early action as the key to prevention, while local data show that hourly checks are documented less than two-thirds of the time. A standardized assessment tool, visible securement and parent partnership offer a practical, measurable initiative aligned with the organization's mission.
References
Gorski, L. A., Hadaway, L., Hagle, M. E., Broadhurst, D., Clare, S., Kleidon, T., Meyer, B. M., Nickel, B., Rowley, S., Sharpe, E., & Alexander, M. (2021). Infusion therapy standards of practice, 8th edition. Journal of Infusion Nursing, 44(1S), S1-S224. https://doi.org/10.1097/NAN.0000000000000396
Park, S. M., Jeong, I. S., & Jun, S. S. (2016). Identification of risk factors for intravenous infiltration among hospitalized children: A retrospective study. PLOS ONE, 11(6), Article e0158045. https://doi.org/10.1371/journal.pone.0158045
Pop, R. S. (2012). A pediatric peripheral intravenous infiltration assessment tool. Journal of Infusion Nursing, 35(4), 243-248. https://doi.org/10.1097/NAN.0b013e31825af323
How this NUR 400 Module 2 example is structured
The first milestone of a quality proposal has to establish three things: that the problem is real, that it matters, and that the proposed initiative is a sensible response. The paper therefore opens with the organization and unit, so the reader knows the setting and its mission. The problem section presents six months of data as counts, rates and severity, with a table. The significance section links the data to patient harm, family experience and cost, supported by published evidence and practice standards. The initiative is then stated precisely, followed by a short section on the leader's role and the questions later milestones will answer.
Get NUR 400 Module 2 written to your instructions
Send your NUR 400 Milestone One guidelines and rubric plus the quality problem and data you have. A sample introduction to your initiative comes back in 24 to 48 hours, free for your first request. The paper above is an original model document written by our desk, not a submitted student paper and not an official Southern New Hampshire University document.
NUR 400 Module 2 questions, answered
What does NUR 400 Module 2 Milestone One usually ask for?
Where the final project runs in milestones, the first one commonly introduces the organization and a quality problem, supported by data, and proposes an improvement initiative. Later milestones address leadership and change theory, planning, implementation and evaluation. Your guidelines list the exact elements required for this first piece.
What kind of data should support a quality improvement proposal?
Use local data where possible, reported as counts with denominators and a time period, such as events per 1,000 catheter-days over six months. Add a benchmark or published rate for comparison, and include severity or harm when available. Data make the problem specific and give the evaluation a baseline.
How specific should the proposed initiative be in Milestone One?
Specific enough that the reader knows what will change and for whom, but without the full implementation plan, which comes later. One or two sentences naming the intervention, the unit and the target outcome is usually right for this stage.