Implementing and standardising the use of peripheral vascular access devices

摘要

Aims and objectives: 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. Background: 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. Design: Implementation of a change management initiative. Methods: 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. Results: 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. Conclusions: 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. Relevance to clinical practice: 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.