Human factor-designed multimodal intervention reduces the rate of unused peripheral intravenous cannula insertion

Diana Egerton-Warburton, Fern McAllan, Radha Ramanan, Zheng Jie Lim, Daniel Nagle, Claire Dendle, Rhonda Stuart

Research output: Contribution to journal › Article › Research › peer-review

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.

Original languageEnglish
Number of pages6
JournalEMA - Emergency Medicine Australasia
DOIs
Publication statusAccepted/In press - 1 Jan 2019

Keywords

  • human factor
  • multimodal intervention
  • peripheral intravenous cannula

Cite this

Egerton-Warburton, Diana ; McAllan, Fern ; Ramanan, Radha ; Lim, Zheng Jie ; Nagle, Daniel ; Dendle, Claire ; Stuart, Rhonda. / Human factor-designed multimodal intervention reduces the rate of unused peripheral intravenous cannula insertion. In: EMA - Emergency Medicine Australasia. 2019.
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title = "Human factor-designed multimodal intervention reduces the rate of unused peripheral intravenous cannula insertion",
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, multimodal intervention, peripheral intravenous cannula",
author = "Diana Egerton-Warburton and Fern McAllan and Radha Ramanan and Lim, {Zheng Jie} and Daniel Nagle and Claire Dendle and Rhonda Stuart",
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Egerton-Warburton, D, McAllan, F, Ramanan, R, Lim, ZJ, Nagle, D, Dendle, C & Stuart, R 2019, 'Human factor-designed multimodal intervention reduces the rate of unused peripheral intravenous cannula insertion' EMA - Emergency Medicine Australasia. https://doi.org/10.1111/1742-6723.13165

Human factor-designed multimodal intervention reduces the rate of unused peripheral intravenous cannula insertion. / Egerton-Warburton, Diana; McAllan, Fern; Ramanan, Radha; Lim, Zheng Jie; Nagle, Daniel; Dendle, Claire; Stuart, Rhonda.

In: EMA - Emergency Medicine Australasia, 01.01.2019.

Research output: Contribution to journal › Article › Research › peer-review

TY - JOUR

T1 - Human factor-designed multimodal intervention reduces the rate of unused peripheral intravenous cannula insertion

AU - Egerton-Warburton, Diana

AU - McAllan, Fern

AU - Ramanan, Radha

AU - Lim, Zheng Jie

AU - Nagle, Daniel

AU - Dendle, Claire

AU - Stuart, Rhonda

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N2 - 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.

AB - 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.

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Egerton-Warburton D, McAllan F, Ramanan R, Lim ZJ, Nagle D, Dendle C et al. Human factor-designed multimodal intervention reduces the rate of unused peripheral intravenous cannula insertion. EMA - Emergency Medicine Australasia. 2019 Jan 1. https://doi.org/10.1111/1742-6723.13165

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