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https://hdl.handle.net/2440/123336
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Type: | Journal article |
Title: | Human factor-designed multimodal intervention reduces the rate of unused peripheral intravenous cannula insertion |
Author: | Egerton-Warburton, D. McAllan, F. Ramanan, R. Lim, Z.J. Nagle, D. Dendle, C. Stuart, R. |
Citation: | Emergency Medicine Australasia, 2019; 31(3):372-377 |
Publisher: | Wiley |
Issue Date: | 2019 |
ISSN: | 1742-6723 1742-6723 |
Statement of Responsibility: | Diana Egerton-Warburton, Fern McAllan, Radha Ramanan, Zheng Jie Lim, Daniel Nagle, Claire Dendle, and Rhonda Stuart |
Abstract: | Objective: Our objective was to examine the impact of a human factor-designed multimodal intervention on the proportion of unused peripheral i.v. cannula (PIVC) insertion in our ED. Methods: A pre- and post-multimodal intervention retrospective cohort study was conducted using a structured electronic medical record review within a single adult tertiary ED in Australia. Pre-intervention data was collected 30 days prior to the multimodal intervention, with 30 day post-intervention data collected 3 months after the intervention commenced. The rates of PIVC inserted, the unused rate and the unused but appropriately inserted cannulas were the main outcome measures. Results: Intravenous cannula insertion rates decreased by 12.9% (95% confidence interval [CI] 12.19-13.61) between the pre-intervention (1413/4167 [33.9%]; 95% CI 32.5-35.4) and post-intervention cohort (928/4421 [21.0%]; 95% CI 19.8-22.2). An analysis of 754 cases (376 pre-intervention and 378 post-intervention) showed that 139 of 376 (37.0%; 95% CI 32.1-42.1) i.v. cannulas were unused pre-intervention, while 73 of 378 (19.3%; 95% CI 15.4-23.7) was unused post-intervention; an absolute reduction of 17.7% (95% CI 14.98-20.42). The relative risk of an unused i.v. cannula was 0.52 (95% CI 0.41-0.67). The proportion of unused but appropriately inserted i.v. cannulas remained unchanged in both cohorts, with a relative risk of 0.91 (95% CI 0.58-1.42). Conclusion: Our multimodal intervention successfully reduced the number of unused PIVCs inserted in the ED, with a reduction in overall and unused PIVC insertions without any change in appropriate insertions. |
Keywords: | Human factor; multi-modal intervention; peripheral intravenous cannula |
Rights: | © 2018 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine |
DOI: | 10.1111/1742-6723.13165 |
Published version: | http://dx.doi.org/10.1111/1742-6723.13165 |
Appears in Collections: | Aurora harvest 4 Medical Sciences publications |
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