Intravenous specialist nursing teams in Qingdao’s tertiary hospitals: current status, resource stratification, and global implication

Background: Intravenous (IV) specialist nursing teams are critical to infusion safety and patient outcomes, yet global hospital resource disparities persist. Existing research on IV therapy mainly focuses on China’s provincial tertiary Grade A hospitals, lacking quantitative analysis of how hospital grade impacts IV therapy quality in prefecture-level tertiary hospitals-a gap common in most upper-middle-income countries. Thus, this study aims to fill this gap, explore the relationship between hospital grade and IV therapy quality in prefecture-level tertiary hospitals, and provide evidence for optimizing IV therapy management in such contexts.

Methods: A STROBE-aligned cross-sectional study was conducted on 30 Qingdao tertiary hospitals (18 Grade A, 12 Grade B) via stratified random sampling (September–December 2024). A validated questionnaire [Cronbach’s α=0.87, scale-content validity index (S-CVI) =0.90] collected data on IV therapy hardware, specialist teams, and quality indicators. Spearman rank correlation, chi-square, and Mann-Whitney U tests were used for statistical analysis (two-sided, P<0.05).

Results: The effective response rate was 100%. Overall, 86.7% of hospitals had IV specialist nursing teams (11.1% of Grade A, 16.7% of Grade B hospitals lacked them); 60.0% had Pharmacy Intravenous Admixture Service (PIVAS), and 93.3% adopted safety-type peripheral venous catheters. Hospital grade was moderately positively correlated with IV specialist nurse allocation rate [r=0.48; 95% confidence interval (CI): 0.18–0.70; P=0.006] and weakly-to-moderately correlated with ultrasound-guided puncture rate (r=0.39; 95% CI: 0.05–0.66; P=0.03). IV specialist nurses’ working years showed moderate positive correlation with complication reporting system establishment rate (r=0.52; 95% CI: 0.21–0.74; P=0.003). Key gaps included low needle-stick prevention steel needle adoption (8.3%) and non-standard specialized dressing change kit use (20.0–26.7%).

Conclusions: Qingdao’s tertiary hospitals have a solid IV therapy foundation, but significant grade-based resource stratification exists between Grade A and Grade B hospitals, with critical gaps in safety tools and standardized maintenance. Hospital grade and IV specialist nurses’ experience are key drivers of IV therapy quality. Optimizing tiered resource allocation, mandating standardized safety tool use, and establishing an experience-aligned incentive loop for IV specialist nurses are core measures. This study provides a replicable model for upper-middle-income countries.