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Effects of a Systematic Quality Improvement Process to Decrease Complications in Trauma Patients With Prehospital

Angie Garrett1, Stacy A Drake, John B Holcomb

  • 1Red Duke Trauma Institute, Memorial Hermann Texas Medical Center, Houston (Ms Garrett); The University of Texas Health Science Center at Houston School of Nursing (Dr Drake); Center for Translational Injury Research, and McGovern School of Medicine, The University of Texas Health Science Center at Houston (Dr Holcomb).

Journal of Trauma Nursing : the Official Journal of the Society of Trauma Nurses
|July 11, 2017
PubMed

Insights

Implementing targeted interventions significantly reduced peripheral intravenous (PIV) catheter complications in trauma patients. This performance improvement project demonstrates a successful strategy for enhancing patient safety and care quality in emergency settings.

Area of Science:

  • Emergency Medicine
  • Trauma Surgery
  • Nursing Practice

Background:

  • Peripheral intravenous (PIV) catheterization is a frequent procedure with potential for serious, costly complications.
  • A cluster of 7 severe PIV complications from prehospital insertions prompted an investigation at a Level I trauma center.

Purpose of the Study:

  • To identify the root causes of PIV complications.
  • To review and improve current nursing practices related to PIV insertions.

Main Methods:

  • Utilized the FOCUS-Plan Do Check Act (PDCA) methodology for performance improvement.
  • Monitored interventions and outcomes rigorously.

Main Results:

  • Following intervention implementation, zero PIV complications were reported for 39 consecutive months.
  • The project successfully mitigated limb-threatening infectious and noninfectious complications.

Conclusions:

  • Performance improvement initiatives can effectively reduce PIV complications in trauma centers.
  • Findings support further controlled studies to establish best practices nationally.

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