Ms. Sue Atkins1, Ms. Jeanette Bell1, Mrs. Sally Roberts1,2, Mrs. Lynette Lennox1, Mrs. Nikki Grae1
1Health Quality & Safety Commission, New Zealand, 2Health New Zealand, Te Toku Tumai Auckland, New Zealand
Biography:
Sue is a New Zealand-trained registered nurse who has returned to Aotearoa New Zealand after working in infection prevention and control in Australia for 22 years. While in Australia, Sue worked in the health care and government sectors, and was last employed by the Department of Health in Victoria for 12 years as a regional infection control advisor. In August 2023, Sue was appointed to a fulltime infection prevention and control specialist role at the Health Quality & Safety Commission New Zealand.
Abstract:
Background
Healthcare-associated Staphylococcus aureus bacteraemia (HA-SAB) rate in Aotearoa New Zealand (NZ) has increased from 0.11 in 2012 to 0.15 events per 1000 bed days in 2023. Since July 2022 the source for all HA-SAB events has been reported.
From July 2022-December 2023, there were 728 HA-SAB events. Invasive medical devices accounted for 69% of all events of which 92% were vascular access devices, with 48% of these associated with peripheral intravenous catheters (PIVC).
To reduce PIVC-related HA-SAB, Te Tāhū Hauora Health Quality & Safety Commission (Te Tāhū Hauora) is undertaking a quality improvement initiative to improve processes associated with PIVC use. The first steps were to understand clinician and consumer experiences on PIVC insertion, maintenance, and removal.
Method
We engaged with clinicians through workshops and a ThoughtExchange online platform, and with consumers through a survey and interviews.
Results
Workshops identified 502 factors contributing to PIVC infections and 398 ideas for improvement. The ThoughtExchange contributed 269 thoughts on contributing factors. The most common themes were poor aseptic technique, sub-optimal use of lines, inadequate monitoring, unskilled staff, lack of patient engagement, and environmental factors.
In the consumer survey and subsequent interviews consumers shared their experience and impact of having an infection on their whānau and their recovery.
Conclusion
HA-SAB events continue to increase in Aotearoa New Zealand, with PIVC as a major contributor. Te Tāhū Hauora next steps are to address the identified contributing factors and the consumer experiences, aiming to improve processes associated with PIVC use.