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The safe insertion of peripheral intravenous catheters : a mixed methods descriptive study of the availability of the equipment needed
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Franklin, Bryony, Deelchand, Vashist, Cooke, Matthew (Professor of clinical systems design), Holmes, Alison H. and Vincent, Charles, Dr. (2012) The safe insertion of peripheral intravenous catheters : a mixed methods descriptive study of the availability of the equipment needed. Antimicrobial Resistance and Infection Control, Volume 1 (Number 1). Article number 15. doi:10.1186/2047-2994-1-15 ISSN 2047-2994.
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Official URL: http://dx.doi.org/10.1186/2047-2994-1-15
Abstract
Background:
Intravenous cannulation is undertaken in a high proportion of hospitalised patients. Much international
attention has been given to the use of care bundles to reduce the incidence of infection in these patients. However,
less attention has been given to the systems required to ensure availability of the equipment needed to support these
care bundles. Our objectives were to assess how reliably the equipment recommended for a peripheral intravenous
care bundle was available for use, and to explore factors which contributed to its non-availability.
Methods:
We studied 350 peripheral cannula insertions in three NHS hospital organisations across the UK. Staff
inserting cannulae were asked to report details of all equipment problems. Key staff were then interviewed to identify
the causes of problems with equipment availability, using semi-structured qualitative interviews and a standard coding
frame.
Results:
47 equipment problems were recorded during 46 of 350 cannulations, corresponding to a reliability of 87%,
or 94% if problems with sharps disposal were excluded. Overall reliability was similar in all three organisations, but the
types of problem varied. Interviews revealed a variety of causes including issues associated with purchasing policies,
storage facilities, and lack of teamwork and communication in relation to reordering. The many human factors related
to the supply chain were highlighted. Often staff had adopted work-arounds to deal with these problems.
Conclusions: Overall, 87% of cannulations had the correct and functional equipment available. Different problems
were identified in different organisations, suggesting that each had resolved some issues. Supply chain management
principles may be useful to support best practice in care bundle delivery.
Keywords:
Cannulation, Patient safety, Equipment, Care bundles, Hospital acquired bacteraemia, Systems reliability
Item Type: | Journal Article | ||||
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Subjects: | R Medicine > R Medicine (General) R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine |
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Catheters, Medical instruments and apparatus, Intravenous catheterization, Nosocomial infections, Patients, Hospitals -- Administration | ||||
Journal or Publication Title: | Antimicrobial Resistance and Infection Control | ||||
Publisher: | BioMed Central Ltd. | ||||
ISSN: | 2047-2994 | ||||
Official Date: | 2012 | ||||
Dates: |
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Volume: | Volume 1 | ||||
Number: | Number 1 | ||||
Page Range: | Article number 15 | ||||
DOI: | 10.1186/2047-2994-1-15 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Open Access (Creative Commons) | ||||
Date of first compliant deposit: | 1 August 2016 | ||||
Date of first compliant Open Access: | 1 August 2016 | ||||
Funder: | Health Foundation (Great Britain) (HF), National Institute for Health Research (Great Britain) (NIHR), UK Clinical Research Collaboration (UKCRC) |
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