Register for citation alerts

How to reduce inappropriate peripheral IV cannulation in the ED?

The intervention focused on improving appropriate use of PIVCs in an emergency setting by emphasizing to clinicians that a PIVC should only be placed if it was believed there was more than an 80% chance that it would be used” Rangarajan et al (2018).

Abstract:

This is a prospective before-after study comparing peripheral intravenous cannulation (PIVC) placement and usage rates following a 10 week long multimodal intervention provided to medical and nursing staff working in a tertiary emergency department (ED). The intervention focused on improving appropriate use of PIVCs in an emergency setting by emphasizing to clinicians that a PIVC should only be placed if it was believed there was more than an 80% chance that it would be used. Patients were eligible for the study if they presented to the ED and were >18 years of age. Patients were excluded from the study if they were triage category 1, already had a PIVC placed in an ambulance, or were transferred from another hospital. Among the 4172 patients included in the analysis, there was a 9.8% reduction in the number of PIVCs inserted (95% CI 6.8-12.87) and a 12% increase in PIVC usage (95% CI 8.7-17.0%) in the post-intervention cohort.

Reference:

Rangarajan, S., Morgenstern, J., Milne, W.K. and Heitz, C. (2018) Hot off the Press: SGEM#197: Cannulation in the ED. Academic Emergency Medicine. February 16th.

doi: 10.1111/acem.13390.

Thank you to our partners for supporting IVTEAM