ED rethinks approach to intravenous insertions

There has been a 30 percent reduction in intravenous (IV) insertions – one of the most common invasive clinical procedures performed at Wellington Regional Hospital’s emergency department (ED).

The Practice Responsible IV Cannulation Today (PRICT) project was introduced by ED nurse Lynne Gledstone-Brown (image attached).

It was focused on encouraging doctors and nurses to assess whether there was a clear need to insert an IV to administer medication or fluid into a patient.

It took only four months for the changes to have an impact. The 30 percent reduction has not only meant patients are avoiding unnecessary pain, it’s also saving around $72,000 a year in needles and cannulas.

“Research shows that 50 percent of patients presenting to ED who receive IV cannulation insertions don’t need them,” Gledstone-Brown said.

“That’s half of the IV cannulation insertions performed a day that are made on a ‘just in case’ basis and are effectively unused. This project was focused on doing what’s right for patients, based on what they actually need.

“There has been a massive cultural shift across the hospital and the departments. ED doctors and nurses are working closely together to make decisions around whether the administration of IV fluids or medication is necessary.”

Lynne is now working with 10 other DHBs to garner interest in implementing the new guidelines in their EDs. Her work has been published in the medical journal Emergency Medicine Australasia, which is the supporting evidence used to implement the PRICT project.

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