Abstract: Background This is a preliminary multi-center survey for the study on the impact of a pediatric infusion management program on the outcome of infusion therapy under a self-controlled pre-and post-experiment design. The management program is based on Clinical Practice Guideline on Infusion Therapy in Children. Objective To investigate the current situation of pediatric nurses′ knowledge, attitude and behavior related to infusion extravasation. Design Questionnaire survey. Methods Based on the theory of knowledge, attitude and behavior, an initial questionnaire with 23 items in 3 sections of knowledge, attitude and behavior was drawn up. After the item analysis, there were 6, 4 and 6 items kept for knowledge, attitude and behavior respectively. The content validity of the items in the attitude and behavior sections was 0.82 to 1.00, and the content validity of the questionnaire level was 0.92. KMO test coefficient of structural validity was 0.807 in attitude and behavior. The result of Bartlett test was P＜0.01 and all items are loaded on with only one main factor ＞ 0.5. The Cronbach's α coefficients of attitude and behavior sections are 0.752 and 0.818 respectively. The nurses participating in clinical work for over 40 weeks in the past year and performing infusion independently or under guidance were recruited from the pediatric wards of 9 hospitals with close academic exchanges with the Nursing Department of Children's Hospital of Fudan University to complete an electronic questionnaire through the platform of Wenjuanxing. Main outcome measures Scores of knowledge, attitude, and behavior. Results Among 3,395 sent questionnaires, 2,568 were returned, and 2,210 were valid. Among 2,210 respondents, 21.8%, 15.9%, 34.9%, 11.1% and 29.8% was respectively from the children's hospital affiliated to the university, the pediatric ward of university-affiliated general hospital, the provincial children's hospital, the municipal children's hospital and the municipal maternal and child health hospital. In terms of working experience, those who have worked for ≤5 years, 5 to 10 years, 10 to 15 years and >15 years accounted for 25.6%, 35.3%, 25.6% and 13.5% respectively. For professional titles, 66.1%, 31.6% and 2.4% of them was junior, intermediate and senior titles respectively. Charge nurses, specialists and teaching nurses, and head nurses accounted for 81.0%, 14.7% and 43% respectively. Among the respondents, 2.8% did not participate in infusion training, 41.0% only participated in a training organized by departments, 45.7% participated in both department-level and institute-level training at the same time, and 9.4% participated in the infusion training by departments, institutes and higher-level organizations at the same time. In total, 22.6% of the subjects only had used peripheral intravenous catheters; 14.9% had used both peripheral intravenous catheters and midline catheters at the same time; and 62.4% had used both peripheral venous access devices and central venous access devices at the same time. There was 82.9% only with experience in inserting peripheral intravenous catheters, 11.1% in inserting both peripheral intravenous catheters and midline catheters and 5.9% in inserting both peripheral venous access devices and central venous access devices. The total score of knowledge section was (12.98±6.95) with good, medium and poor grade accounting for 8.6%, 5.5% and 75.9% respectively. The total scores of attitude and behavior were (17.23±2.58) and （23.45±4.14) respectively. There was significant difference in the correlation test between knowledge section and attitude (r=0.066) and behavior section (r=0.100) (P=0.002). Multivariate linear regression analysis showed that hospital type, number of training levels and types of venous access devices used by nurses were the influencing factors of knowledge and behavior scores. The number of training levels is the influencing factor of attitude score of the three factors. Conclusion The knowledge, attitude and behavior of pediatric nurses about infusion extravasation did not show the trend of unity and order.

Key words: Extravasation, Pediatric nurse, Knowledge, Attitude, Behavior