Mrs. Lynda PARRIS1, Ms Emma Allomes1
1Sir Charles Gairdner Hospital, Perth, Australia
Biography:
Lynda and Emma job share a Clinical Nurse Consultant position at a tertiary hospital in Perth. They come from a background in Oncology nursing, and are very passionate about patient centred care. Now working in the field of vascular access, they are champions for infection prevention and quality improvement.
Abstract:
Historically, root cause actions from recurring Peripheral Intravenous Catheter (PIVC) Staphylococcus Aureus blood stream infections (SABSI) have consistently and repetitively attempted to ‘re-educate’ Doctor’s PIVC insertion practices. Unfortunately, there has been no evidence that this has resulted in adequate improvement in associated infection rates to date.
Taking a necessary look-back at the bigger picture indicates a wider understanding of these procedural failure modes and has led to the start of an innovative quality improvement pathway via an expanded nurse led specialist ‘difficult intravenous access’ (DIVA) PIVC insertion service…..“Gloves On!”
The clinical expertise of the nurse led Vascular Access Service is an asset within our hospital and has sights upon acceptance into the established circles of influence. With our newly expanded service, we hope that “times (and practices) are a changing.”
Engaging into the established circles of influence should help navigate the challenges, with the aim of overcoming the barriers to support the necessary changes.
The expanded nurse led service aims to increase the sphere of control to over 60% of DIVA PIVC insertions within the hospital setting.
Is that enough? Will our wider sphere of influence expand sufficiently so that the necessary quality improvement aspiration towards 100% of DIVA insertions and 0% infection rates follow?