Innovation through implementation of a bundle of care to reduce risk of infection associated with Peripheral Intravascular Devices in THS North West

Mrs Anne Jong¹, Ms  Tana Clark, Ms Heather Craigie¹

¹Mersey Community Hospital, Latrobe, Australia

Abstract:

Introduction:
Peripheral Intravenous Catheters (PIVC) are inserted in up to 70% of hospital inpatients.  Up to 69% of these experience premature failure due to complications, the most serious is Staphylococcus Aureus Bacteraemia (SAB) which can have fatal outcomes. In 2018-19 we identified a rise in SAB’s associated with PIVC.  Evidence shows that implementing a bundle of care is more effective than introduction of a single action.

Method:
A working party was established comprising Clinical Nurse Consultants across both regional sites and a Clinical Nurse Educator with responsibility for Vascular Access (NQSHC Standard 2).  A bundle of care a was developed that built on existing improvement strategies and included the I-DECIDED Intravenous Assessment and Decision Tool, developed by Dr Gillian Ray-Barruel from the AVATAR group from Griffith University.

The acronym HANDS was adopted,

• Hand Hygiene
• Antisepsis & Standardised Equipment
• Non-Touch Technique
• Documentation and Observation (I-DECIDED Intravenous Assessment and Decision Tool)
• Staff

Preliminary planning included approval to use the I-DECIDED tool, stakeholder engagement and education, updating of current protocols to reflect the introduced bundle of care, plan for rollout, and an evaluation plan

Results:
The bundle of care was rolled out over second half of 2019 and we are currently in the evaluation phase of the project.

Discussion:
THS-NW is one of the first health services to introduce I-DECIDED.  Coupled with a bundle of care and a planned implementation, we found clinical staff have been receptive to change and rollout has been uncomplicated. Planned auditing will show if this change has been effective.

Reference

1. Ray-Barruel G, Cooke M, Mitchell M, et al. Implementing the I-DECIDED clinical decision-making tool for peripheral intravenous catheter assessment and safe removal: protocol for an interrupted time-series study. BMJ Open 2018;8:e021290. doi:10.1136/ bmjopen-2017-021290

Biography:

Anne works at the Mersey Community Hospital in Latrobe. Has been a surgical Clinical Nurse Educator for 10 years with interests in acute pain management, wound management, vascular access and infection control. Currently working in the THS north west Infection Prevention and Control department.