Audit of peripheral venous cannulae by members of an IV therapy forum

Abstract

This article describes a clinical audit of peripheral venous cannulae (PVC) undertaken by members of a national intravenous therapy forum. PVC care was reviewed using the RCN 'Standards for Infusion Therapy' and the Department of Healh's 'Winning Ways' report, action area 2 (DH, 2003; RCN, 2003) to define best practice. Data were collected by members of the forum and submitted for analysis by the members' coordinator. The findings of the audit highlighted several areas for improvement in PVC care. The most significant finding was poor documentation of the insertion of the cannula. An additional concern was that the person who performed the cannulation could not be identified for 236 (37.7%) of PVC audited. Draft recommendations with strategies for implementation have been proposed and feedback sought from participants with plans to re-audit in 2007.

Nurses’ clinical reasoning concerning management of peripheral venous cannulae

“…Nurses are responsible for making decisions about what is best for the individual patient and perhaps 100% guideline adherence is not desirable at all times. Bravery et al. (2006) suggest that an adherence rate of 85% should be considered adequate.…”

“…Adherence to PVC‐guidelines vary in different settings (Ahlqvist et al. 2006, Biswas 2007, Bravery et al. 2006, Couzigou et al.…”

“…There may be differences between clinical reasoning in simulated situations and real situations where the individual is exposed to environmental factors (Orasanu & Connolly 1993, Fonteyn & Ritter 2000. Adherence to PVC-guidelines vary in different settings (Ahlqvist et al 2006, Biswas 2007, Bravery et al 2006, Couzigou et al 2005, Eiman Johansson et al 2008, Wiechula & Hodgkinson 2002, but the reasons are not clear. Knowledge of the clinical information and circumstances actually considered by nurses during clinical reasoning is needed for understanding why nurses sometimes deviate from CPGs and may lead to CPG modifications or different implementation strategies.…”

Accuracy in documentation – a study of peripheral venous catheters

“…However, several studies have found that PVC insertion is poorly documented (Lundgren & Wahren 1999, Ahlqvist et al. 2006, Bravery et al. 2006, Biswas 2007).…”

“…In addition to insertion time, recorded PVC data comprising lumen size, anatomic insertion site and patient's left-or right-hand side have been considered satisfactory to ensure patients an effective continuity of PVC care (Lundgren et al 1996, Couzigou et al 2005. However, several studies have found that PVC insertion is poorly documented (Lundgren & Wahren 1999, Ahlqvist et al 2006, Bravery et al 2006, Biswas 2007. A common concern regarding nursing documentation is that nursing notes fail to provide information about the actual care given (Briggs & Dean 1998, Ehrenberg & Ehnfors 2001.…”