Senior Research Assistant, Griffith University
The aim of this study was to gain a ‘real world’ overview of current intravenous care and maintenance practice by nursing staff. Research has quantified the unacceptably high failure rate of peripherally inserted venous catheters (PIVCs) prior to completion of prescribed treatment (ranging from 26%-44%).
This was a single center prospective, observational study, of intravenous (IV) medication and flush administration on surgical and medical wards of a tertiary metropolitan hospital. Participants included Registered Nurses and Endorsed Enrolled Nurses from 2 wards, experience ranging from new graduate to >20 years. Consenting nurses were observed over an 8 hour shift whilst administering IV medications or flushes.
Most PIVCs were in for a reason i.e. antibiotic administration. It was identified that IV drugs were administered by infusion or bolus. Poor adherence to infection control was evident with a third of nurses not following aseptic non-touch technique (ANTT), half not fully observing hand hygiene and limited decontamination of the needless connector. Flushing practice was found to be inconsistent with bag and burette delivery.
The implications for practice are that the importance of hand hygiene and ANTT principles need to be highlighted to improve compliance. This includes the use of personal protective equipment. Further evidence on needleless connector decontamination, including scrubbing & drying times is required. We need to re-educate the value of flushing for all PIVCs with a focus on, maintaining patency, prevent mixing of incompatible drugs and early detection of failure.