Dr Samantha Quoy1, Dr Charmaine Lye1, Dr Lachlan Wasson1, Dr Randy Tjang1, Dr Emma Watson1, Dr Sarah Browning1,2,3
1Hunter New England Local Health District, New Lambton Heights, Australia, 2Infection Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia, 3School of Medicine and Public Health, University of Newcastle, Callaghan, Australia
Biography:
Dr Samantha Quoy is a Junior Medical Officer Infection Prevention and Control Champion within the Hunter New England Local Health District, and a Conjoint Associate Lecturer at the University of Newcastle. Dr Quoy has played an instrumental role in supporting her peers in best practice cannulation, and is passionate about improving patient safety through participation in quality improvement projects and promoting infection prevention and control.
Abstract:
Background
Antecubital fossa (ACF) peripheral intravenous cannulas (PIVCs) account for greater than 50% of cannula-associated Staphylococcus aureus bloodstream infections (SABSIs) within our local health district each year. In this Junior Medical Officer-led quality improvement project, we explore ACF PIVC prevalence and interview nursing staff, with an aim to identify and address barriers to timely ACF PIVC removal across 4 wards in one tertiary hospital.
Methods
Five weekly point prevalence audits and staff interviews were completed across two medical and two surgical wards, providing baseline data regarding ACF PIVC prevalence, dwell time and barriers to timely removal. Patient satisfaction with PIVC management was measured throughout. In a planned intervention phase, barriers will be sequentially addressed using a ‘Plan, Do, Study, Act’ (PDSA) quality improvement model, with the aim of reducing the prevalence of ACF cannulas by 50% over a 3-month period.
Preliminary Results
290 PIVCs were audited, with 15% (43/290) in the ACF. Most ACF PIVCs (45%) had been in situ for greater than 24 hours. 100% of nurses interviewed reported being aware of the need to remove cubital fossa cannulas within 24 hours. Lack of awareness of PIVC dwell time was a reported barrier in 27% of cases, while recent surgery, and ongoing need for PIVC access as per policy, was also common (20%).
Conclusion
ACF PIVCs are a significant risk factor for healthcare associated SABSI. In addressing this issue, barriers that prevent timely removal, as reported by nursing staff, should inform future quality improvement strategies.