Ending the complications

Most of us have needed a 'drip' during a stay in hospital. Worldwide, around 50% of patients admitted to hospitals require the insertion of a peripheral intravenous catheter (PIVC)—the technical name for the 'drip'—to receive IV fluids, medications or blood as part of a normal procedure. It's the most common invasive clinical procedure performed in hospitals. But despite national and international guidelines for standards of practice in the ward, 40% of patients will still have a failed insertion in the course of a treatment.                                                                                                                                                                                                     Dr Evan Alexandrou 

Risk of hospital-acquired infection is increased every time that a drip is inserted into a patient, particularly in developing countries where poor resourcing means that patients have a 20 times higher chance of infection. PIVC failure costs the patient and the health system. It disrupts therapy and causes patient pain and infection;it increases the costs and prolongs the length of the patient's hospital stay.

Despite the consequences of poor PIVC care and management there is little data on prevalence, management and infection prevention practise. Dr Evan Alexandrou has been working with an international team of researchers and clinicians to fill this knowledge gap and identify what clinical practices are most likely to cause failure.

Evan and his team conducted the One Million Global Catheters PIVC Worldwide Prevalence Study (OMG), auditing over 40,000 patients in 450 hospitals in 50 countries. The results are being analysed and will be released in April 2016.

'We will be able to ascertain what contributed to these failure rates', explains Evan, 'then feed that back to clinicians and incorporate these findings into clinical guidelines so that we can improve the care of these patients.'

Hospitals involved in the study have access to their results, providing invaluable information to better train staff in PIVC management.

Already, Evan has identified several issues in common practice including location of insertion. 'If you had a cannula inserted in the hand or in the elbow, it was more likely to fail,' Evan says. More concerning was the discovery that over 45% of patients with a cannula inserted didn't have an IV order for fluids or medication and were placed at unnecessary risk of infection.

'These were redundant cannulas,' says Evan.

This research has had a profound impact on clinical practice both at a local and international level.

'We have been able to develop these findings and are now starting to translate this research into clinical guidelines,' says Evan. 'We are hoping to make IV complications history.'

For further information about the OMG Study please contact Dr Evan Alexandrou.

Ends

March 2016