March 18, 2019

Think before you cannulate

Every year in hospitals the size of Northern Health, there are about 8-10 cases of staphylococcus bacteraemia mostly related to intravenous cannulas. These infections can result in death, but most are preventable.

Northern Health is looking to improve how we care for patients with Peripheral Intravenous Cannulas (PIVCs). During the Safe Practice Forum on Wednesday 20 March, staff will be able to hear more about safe cannulation practices and patient case studies, as well as hear about Northern Health’s new cannulation policy, now available on Prompt (click here to download).

Clare McCarthy, Project Manager, said the three-day focus on cannulation safety is the lead up to an organisation-wide ‘Week of Cannulation Safety’.

“This will occur towards mid-2019, culminating in a re-audit and further education sessions. The week will be organised by front line clinicians to enable and embed local ownership of the campaign,” she said.

The focus on Peripheral Intravenous Cannulation (PIVC) during these three days aims to raise awareness of the risk PIVCs carry in our emergency department and wards, and aims to prevent infection, improve patient safety and reduce the usage of cannulas.

Whilst mainly safe, PIVCs come with the risk of complications. Following all the necessary procedures for the insertion and care of PIVCs is crucial, as they can provide a direct portal of entry for microorganisms and result in bacteraemia, the most common being staphylococcus aureus bacteraemia (SAB).

Northern Health’s focus on patient safety and high reliability has led to revising the old cannulation policy and establishing a new one, which is formed on evidence-based practice.

With the new policy, nursing staff are supported by Northern Health and executive team to remove the PIVC if an ongoing need is not documented – such as ongoing medications, fluids or documented plans for access in the next 12 hours.

Dr Craig Aboltins, Infection Prevention, said that previously, nurses may not have been empowered to remove unused cannulas, as they felt this is something they need instructions from the doctor.

“Recent evidence suggests that care for patients with IV cannulas in a hospital like ours can be improved. Part of this program is to empower the nurses to be able to remove intravenous cannulas. If they are not meant to be used in the next 12 hours, and there are no ongoing intravenous medications, the nurses should remove them,” he said.

Remember – if in doubt, take it out!

In the emergency department, clinicians will be asked to “think before you cannulate.”

Avoiding unnecessary cannulas or cannulas put in “just in case” is a simple way to prevent patients from experiencing both the risk of severe infection and the discomfort associated with a PIVC. A guideline has been developed for use in the emergency department to help advise clinicians which patients should and should not have cannulas.

To hear more from Dr Aboltins about the correct cannulation procedures, patient safety and recent evidence findings, as well as to see a demonstration, please watch the video below.