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A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
Emergency inserted peripheral intravenous catheters: a quality improvement project
Leanne Ruegg1, Mark Faucett2, Keat Choong3
1Clinical Nurse Consultant, Vascular Access Surveillance and Education, Sunshine Coast University Hospital, Birtinya, Queensland, Australia.
Abstract:
Vascular access devices are common and necessary in healthcare provision but their use poses a significant risk of acquiring an infection. Ambulance/emergency inserted peripheral intravenous catheters (PIVCs) potentially have higher risks of catheter-related bloodstream infection (CRBSI) because of the inability to maintain asepsis during the insertion procedure. Local guidelines (Queensland, Australia) recommend the removal or replacement of PIVCs inserted in these situations within 24 hours. Routine clinical audits performed within the authors' health service demonstrated a delay in removing ambulance/emergency inserted PIVCs beyond acceptable dwell times. Ambulance/emergency inserted PIVCs were not being recognised as requiring removal by ward staff. A quality improvement project involving key stakeholder engagement, the roll out of a sticker to readily identify ambulance/emergency inserted PIVCs and education of ward staff was introduced to enable identification of this high-risk group. Post-implementation audits demonstrated a significant reduction in numbers of ambulance/emergency PIVCs remaining in situ for longer than 24 hours.
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