Most Proposed Topic :
Clinical Safety and Quality Service II (projects aiming to enhance clinical safety and outcomes, clinical governance)
Authors: (including presenting author): :
Lin OY(1), Kwok CC(2), Lam HY(1), Lau HK(3), Chan TC(1)
Affiliation: :
(1) Medicine and Geriatrics, Fung Yiu King Hospital
(2) Medicine and Geriatrics, Duchess of Kent Children's Hospital
(3) Medicine and Geriatrics, MacLehose Medical Rehabilitation Centre
Introduction: :
There were many patients requiring peripheral venous catheter (PVC) for intravenous fluid, antibiotics or nutrition in Sandy Bay Hospitals. PVC can cause multiple complications include phlebitis, infiltration, occlusion/mechanical failure, and dislodgement. An infected peripheral venous catheter site might even cause severe blood stream infection. However, in the past, there were no standardized documentation nor assessment tools for PVC which may lead to unawareness of these complications. Therefore, in April 2023, a working group on care of peripheral catheter was formed in SBHs.
Objectives: :
To develop a standard care plan for peripheral venous catheter in SBHs in order to minimize the PVC complications
Methodology: :
In April 2023, a working group involving infection control team and the ward nurses was formed in SBHs aiming to develop standardized care for PVC in wards. Current practice of training on PVC insertion and catheter care, PVC insertion technique and after care was reviewed. It was noted that there was no standardized documentation nor assessment tools for PVC. Therefore, draft check list for initial documentation and daily review plan for peripheral venous catheter was made. The draft check list was circulated to working group members in June 2023. Working group members then seek for opinions from the members of all respective wards. Fine adjustments were made after receiving all the comments. The final DKCH-FYKH-MMRC Peripheral Venous Catheter Assessment Form was endorsed in mid-July 2023. The check list was subsequently started to be used on 31 Jul 2023 in FYKH, MMRC and DKCH.
Result & Outcome: :
The standardized documentation and review form of peripheral catheter was designed and rolled out smoothly in 3Q 2023. All parties including doctors, nurses, infection control team welcome the new documentation form. Peripheral catheter complication and necessity is monitored regularly. The blocked, infected or unnecessary peripheral catheter would be removed promptly to minimize the harm to patients. Point Prevalence Survey on Bloodstream Infection (BSI) was performed in SBHs in November 2023. Result showed that there were standardized practices of PVC training and care in SBHs. 100% patients with PVC had proper documentation of PVC condition in the DKCH-FYKH-MMRC Peripheral Venous Catheter Assessment Form. There were no patients with PVC was noted to have purulent drainage at PVC site. There were also no blood stream infection during the audit period.
