Implementing and standardising the use of peripheral vascular access devices

CLINICAL ISSUES

Implementing and standardising the use of peripheral vascular access devices

Dean Easterlow, Phill Hoddinott and Stephanie Harrison

Authors:Dean Easterlow, BSc, Dip H.E. RGN, RN, Lead Nurse for Quality & Clinical Services, St. Mary's Hospital, Imperial College Healthcare NHS Trust; Phill Hoddinott, BSc, Dip H.E., RN, Clinical Placements Manager, St. Mary's Hospital, Imperial College Healthcare NHS Trust; Stephanie Harrison, BSc, MSc, RGN, RSCN, Lead Nurse for Quality & Clinical Services, St. Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK

Correspondence to Dean Easterlow, Lead Nurse for Quality & Clinical Services, St. Mary's Hospital, Imperial College Healthcare NHS Trust, Praed Street, London W2 1NY, UK. Telephone: +44

0207 886 1124.

E-mail:Dean.Easterlow@https://www.wendangku.net/doc/3a1153894.html,

Financial support from Becton Dickinson was provided only for editorial support in developing this manuscript.

KEYWORDS

cultural change ? healthcare-acquired infection ? non-ported cannula ? nurses ? nursing

ABSTRACT

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.

临床议题

外周血管通路设备的实施与标准化

翻译：林征南京医科大学护理学院

审校：陆亮澳门镜湖护理学院

关键词：文化变革；医疗获得性感染；非隧道式套管；护士；护理

目的与目标：评估英国伦敦一家急诊医院一项有关在医疗获得性感染上使用外周静脉插管的改变创新行动的影响。

背景：近年来英国的医院获得性感染的发生率在增加，其原因包括不良实践及在医疗机构中清洁和卫生标准的下降。

设计：实施一项管理改革的创新行动。

方法：先进行一项基线审核以确定改革的范围。基于审核结果，实施一项变革创新行动包括引入一种新的、非隧道式安全套管针，同时改变与外周静脉插管相关的护理实践。

结果：与改革前比较，在新的套管使用八个月后，耐甲氧西林金黄色葡萄球菌数及医院获得性感染的病例数分别减少了53%和35%。审核结果还表明在随着改变创新行动执行后，有关套管照顾的实践上有相当大的改善。

结论：通过文化变革，采用非隧道式套管以及对与外周静脉插管照顾相关的临床实践进行改进，在研究的时段内可明显降低医疗获得性感染。

临床实践相关性：采用适当的套管和使用套来减低感染的风险有助于减少在外周静脉导管应用中耐甲氧西林金黄色葡萄球菌和医疗获得性感染的发生。通过培训和支持，鼓励采用最佳的实践做法，结合定期的跟进审核，可以降低感染率，提高导管线照顾的质量。本研究为同类型机构提供了证据以引导对导管照顾的决策。