Dr Louise Hobbs1 Dr Craig Aboltins3, Stephanie Lowe1, Associate Professor Kirsty Buising1,2
1Safer Care Victoria, Melbourne, Australia,
2Melbourne Health, Melbourne, Parkville, Australia,
3Northern Health, Melbourne, Sunshine, Australia
A review of the Victorian Staphylococcus aureus bloodstream infections (SAB) data identified that a proportion were attributed to peripheral intravascular cannula (PIVC) use, and thus may have been potentially preventable.
To co-design with stakeholders an effective, practical and sustainable bundle of interventions to reduce PIVC associated SABs in hospitals across Victoria.
A Victorian reference group of twelve multidisciplinary members was convened by Safer Care Victoria. This group comprised medical, nursing, consumer and surveillance groups from rural and urban settings, covering both paediatrics and adult hospitals. Using an experience mapping technique the group identified four key areas for focused improvement and several evidence based change ideas were proposed and displayed as a driver diagram. The top three change ideas were then identified using an impact-effort matrix and ranking technique. These will form the basis of the PIVC bundle.
The top three change ideas involved interventions addressing insertion, maintenance and review of cannulas. The bundle will be tested and iteratively refined using plan-do-study-act cycles in self nominated pilot healthcare services. The results of the plan-do-study-act cycles will be presented along with identified process and balance measures.
The project will demonstrate the application of a quality improvement framework at a state level may provide a platform to design practical interventions to reduce patient harm associated with PIVCs.