Mrs. Leasa Giles1
1Tasmanian health, Launceston, Australia
Biography:
Leasa is a Registered Nurse with 37 years’ experience, with a specific focus on ophthalmic surgery before moving to Infection Prevention and Control.
Leasa has completed a graduate certificate in Infection Prevention and Control at Griffith University, and a certificate IV in training and assessment and certificate IV in sterilising services.
Experiencing both public and private sectors at tertiary facilities, regional hospitals and day surgery services in QLD and NSW.
Leasa currently works as an IPC Clinical Nurse Educator, employed by Tasmanian Health Service. Working in the current healthcare climate in Tasmania, the role is both challenging and extremely rewarding.
Abstract:
Hospitals North Tasmania noted increased Staphylococcus aureus bloodstream infections (SABSI) rate from June 2022 through 2023, peaking at 2.40 per 10 000 OBDs December 2023. The Vascular Access Committee (VAC) identified areas of concern with current SABSI rates. VAC escalated the risk to hospital management resulting in engagement of a Clinical Nurse Educator position to undertake a review of practice against the Clinical Care Standard.
Auditing identified significant issues with Peripheral IV Cannula (PICV) review and documentation. Process changes included:
– Removal of PIVC and incident reporting of all PIVC with a VIP (visual infusion phlebitis) score ≥ 1
– Focus on removing PIVC inserted by external facilities within 24hrs.
– Quality reporting system upgraded enabling VIP score reporting across category 0 -5, allowing identification of contributing factors and systems issues.
Previous incident reporting of elevated VIP score averaged 25 per month, implementation of the new reporting definitions increased reporting and canula removal on average to 60 per month in 2024.
Outcomes
From January to April 2024, 238 elevated VIP scores were reported.
– 89% were for VIP scores 1 and 2.
– 11% were for VIP scores 3 to 5.
– SABSI rate peaked at 2.40 in December 2023
– January to April 2024 the SABSI rate is now 0.37 per 10 000 OBDs.
On reflection I wonder if “perhaps that is enough” to reduce SABSI rates and risk to patients, ongoing surveillance will tell.