Dr Sarah Sparham1,2, Mr Daniel Kim1
1Eastern Health, Box Hill, Australia, 2Monash University, Clayton, Australia
Biography:
Dr Sarah Sparham is an Infectious Diseases physician at Eastern Health, a large health service in metropolitan Melbourne. She holds the role of Medical Lead, Infection Prevention and Control and her interests include enhancing patient care and outcomes via quality improvement, infections in people who inject drugs, and general ID.
Abstract:
In 2023, Eastern Health recorded increased Staphylococcus aureus bacteraemia (SAB) rates, resulting in patient harm, increased length of stay, and outlier status compared with the national benchmark. This occurred despite the implementation of initiatives aimed at reducing SAB rates.
We identified that the majority of our approximately 40 annual SABs were associated with peripheral intravenous cannulas (PIVCs) and were therefore potentially preventable. Of these, most were inserted in our Emergency Departments (ED), in an area of flexion, and with a dwell time greater than the 48 hours recommended in our local guidelines.
Immediate actions included strengthening the clinical governance of PIVC practice through the establishment of a PIVC Governance Committee, focused initially on improving identification of PIVCs inserted in ED using coloured stickers. This allowed ward staff to easily recognise these PIVCs to support timely removal or re-insertion as per our local guidelines. To reinforce safe PIVC practices, an awareness campaign was launched, featuring weekly learning activities and targeted education.
Since introducing the PIVC initiative in 2023, Eastern Health has achieved a sustained reduction in SAB rates. As of May 2025, we have met the national benchmark for nine consecutive quarters and had one of the lowest SAB rates in the major hospital category, (0.2 incidents per 10,000 occupied bed days). This initiative is ongoing, with a monitoring and reporting system embedded into business-as-usual.
We conclude that sustained practice change requires whole-of-service engagement in additional to local-level ownership. Importantly, we have learned that simple solutions can have a profound impact.