Taking the Ouch from the Patient

Mrs Ann Whitfield1

1Fiona Stanley Fremantle Hospitals Group, Perth , Australia 


In 2016 Healthcare Associated Staphylococcus aureus blood stream infections (HA-SABSI) by invasive devices were above peer comparisons at Fiona Standley Hospital (FSH). Reducing harm from invasive devices and significant infections was a priority for the organisation. From the investigations, evidence showed that there was a variance in invasive device insertion and management.


The aim was to reduce harm from invasive devices and in early 2017 under Nursing leadership a group of experts in medical/nursing/allied health formed an Invasive Device Working Group to review the evidence:

Key interventions:

  • Literature reviews included identifying the barriers and safe care of invasive devices.
  • Standardising products (including insertion packs, dressings and skin preparation), insertion bundles, policies and aseptic technique.
  • Sustainability for reducing harm included; auditing, training, and visual reminders.
  • Communicated the vision of IP excellence and patient-centric healthcare.


The measurement and sustainability of the program was by patient outcomes which the Infection Prevention Nursing experts provided a proactive surveillance program capturing and reporting HA-SABSI on the Datix Clinical Incident Management System. In addition, the Invasive Device Working Group action log tracked over 50 improvement actions undertaken within 18 months.


There has been a 25% reduction from HA-SABSI by invasive devices over the last 12 months, with long lines.


Implementing standardised processes for invasive devices with policy, training, insertion and management bundles improves patient outcomes. Having a Nurse led program empowered practices and linked into current governance systems and key performance indicators.


Ann Whitfield is the Coordinator for Infection Prevention at Fiona Stanley Fremantle Hospitals Group and is credentialed with the Australasian College for Infection Prevention and Control.

Ann’s research interests include culture changes, building capacity in small teams, invasive devices and consumer involvement.

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