Implementing and standardising the use of peripheral vascular access devices

To assess the impact of a change initiative relating to the use of peripheral intravenous cannulae on healthcare-acquired infections in an acute hospital trust in London, UK.

The prevalence of healthcare-acquired infections has increased in the UK in recent years. Causal factors include poor practice and declining standards of cleanliness and hygiene in healthcare settings.

Implementation of a change management initiative.

A baseline audit was conducted to identify areas for change. Based on the audit findings, a change initiative was implemented which included the introduction of a new, non-ported needle-safe cannula, together with changes in practices relating to peripheral intravenous cannulae care.

In the eight months postintroduction of the new cannulae, decreases of 53% and 35% were reported in the number of methicillin-resistant Staphylococcus aureus and healthcare-acquired infection cases, respectively, compared with the same period prior to implementation. Audits results also demonstrated considerable improvements in practices relating to cannula care following implementation of the change initiative.

A change in culture, the adoption of a non-ported cannula and improvements in practices relating to peripheral intravenous cannulae care led to significant reductions in healthcare-acquired infections during the period of the study.

The adoption of appropriate cannulae and administration sets to minimise infection risk can help to reduce the incidence of methicillin-resistant S. aureus and healthcare-acquired infection cases resulting from peripheral venous cannulation. Training and support to encourage the adoption of best practice, in conjunction with regular follow-up audits, can lead to a reduction in infection rates and general improvements in the quality of peripheral line care. The findings of this study provide similar institutions with evidence to guide decision-making on cannula care.