title: Improving peripheral cannulation practice at an NHS Trust.
abstract: Unplanned recannulations are a common occurrence in a number of hospitals both in the UK and worldwide (Schwengel, 2004; Jackson, 2007). In May 2008 the Clinical Nurse Specialist in IV Therapy at Brighton and Sussex University Hospital (BSUH) NHS Trust initiated a clinical audit to assess i.v. practice and determine the impact of recannulations within the Trust. The audit, which was initially carried out on 1000 sequential cannula insertions, and is currently ongoing, showed that 69.2% of the cannulas failed well before the routine change of 72 hours, and that 36.3% were removed because they had infiltrated. With the aim of reducing these numbers of unscheduled recannulations, the Nurse Specialist initiated a real-time, prospective clinical evaluation of a new cannula stabilization device at BSUH. This assessed the impact of the device alongside the currently used securement strategy (i.v. dressing) on unscheduled i.v. restarts in 50 cannulas compared with the baseline data. During the clinical evaluation, all i.v.s were tracked every 4 hours and all complication/reasons for removal were noted. On initiation of the use of the stabilization device, the infiltration rate was reduced from the baseline level by 100%.There was also an 81% reduction in the rate of unscheduled i.v. restarts. The data from the clinical evaluation demonstrated the considerable benefits of using a cannula stabilization device compared with the current hospital practice of using i.v. dressings only for securement with regard to infiltration levels and unplanned restarts. This device may have significant future benefits in terms of improving patient care and reducing healthcare expenditure.
authors.affiliation: Brighton and Sussex University Hospital NHS Trust.
authors.forename: Debbie
authors.initials: D
authors.lastname: Bolton
mesh_terms: D002406:Catheterization, Peripheral / Q000295:instrumentation / Q000592:standards*; D006779:Hospitals, Public / Q000592:standards*; D006801:Humans; D009731:Nursing Audit; D009741:Nursing Staff, Hospital / Q000592:standards; D013222:State Medicine / Q000592:standards*; D006113:United Kingdom