Nurse-Led Implementation of Evidence-Based Peripheral Intravenous Catheter Care in Pediatrics: A Qualitative Study

BACKGROUND: Peripheral intravenous catheter (PIVC) complications persist in pediatric settings, creating an urgent need for systematic nurse-led practice change. OBJECTIVE: This study explored how nurses facilitated the implementation of an updated evidence-based PIVC insertion protocol through the lens of the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework. METHODS: A qualitative descriptive design was used. Written reflective narratives from 9 nurses were analyzed using hybrid thematic analysis, deductively mapped to i-PARIHS constructs. RESULTS: Four themes were constructed: (1) activating facilitation: relational strategies for enabling change; (2) building recipient readiness: from resistance to engagement; (3) navigating context: organizational enablers and barriers; and (4) embedding the innovation: tools and processes for sustained adoption. CONCLUSION: Consistent with i-PARIHS, nurse-led facilitation functions as the active driver of implementation. Suggestions for application in practice include using relational strategies to enable change, building recipient readiness through individualized engagement, contextual navigation to address organizational barriers, and embedding the innovation through practical tools and sustained follow-up.