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  • Implementing the I-DECIDED clinical decision-making tool for peripheral intravenous catheter assessment and safe removal: protocol for an interrupted time-series study

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    Author(s)
    Ray-Barruel, Gillian
    Cooke, Marie
    Mitchell, Marion
    Chopra, Vineet
    Rickard, Claire M
    Griffith University Author(s)
    Cooke, Marie L.
    Mitchell, Marion L.
    Year published
    2018
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    Abstract
    Introduction: Millions of acute care hospital patients need a peripheral intravenous catheter (PIVC) each year. However, up to half of PIVCs remain in situ when not being used, and 30%–50% of intravenous (IV) catheters develop complications or stop working before treatment is finished, requiring the insertion of a new device. Improved assessment could prompt timely removal of redundant catheters and prevent IV complications. This study aims to validate an evidence-based PIVC assessment and decision-making tool called I-DECIDED and evaluate the effect of implementing this tool into acute hospital clinical practice. Methods ...
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    Introduction: Millions of acute care hospital patients need a peripheral intravenous catheter (PIVC) each year. However, up to half of PIVCs remain in situ when not being used, and 30%–50% of intravenous (IV) catheters develop complications or stop working before treatment is finished, requiring the insertion of a new device. Improved assessment could prompt timely removal of redundant catheters and prevent IV complications. This study aims to validate an evidence-based PIVC assessment and decision-making tool called I-DECIDED and evaluate the effect of implementing this tool into acute hospital clinical practice. Methods and analysis: The protocol outlines a prospective, multicentre, mixed-methods study using an interrupted time-series (multiple measures preintervention and postintervention) implementation at three Australian hospitals between August 2017 and July 2018. The study will examine the effectiveness of the I-DECIDED assessment and decision-making tool in clinical practice on prompting timely PIVC removal and early detection of complications. Primary outcomes are prevalence of redundant PIVCs (defined as device in situ without a clear purpose), IV complications (occlusion, dislodgement, infiltration, extravasation and phlebitis) and substandard dressings (loose, lifting, moist or soiled); device utilisation ratios; and primary bloodstream infection rates. Secondary outcomes including staff barriers and enablers to PIVC assessment and removal, patient participation, documentation of PIVC assessment and decisions taken to continue or remove the PIVC will be recorded. Using the Promoting Action on Research Implementation in Health Services framework, we will undertake staff focus groups, bedside patient interviews and PIVC assessments and chart audits. Patients aged 18 years or more with a PIVC will be eligible for inclusion. Ethics and dissemination: Ethical approval from Queensland Health (HREC/17/QPCH/47), Griffith University (Ref No. 2017/152) and St Vincent’s Health and Aged Care Human Research and Ethics Committee (Ref No. 17/28). Results will be published. Trial registration number: ANZCTR: 12617000067370; Pre-results.
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    Journal Title
    BMJ Open
    Volume
    8
    Issue
    6
    DOI
    https://doi.org/10.1136/bmjopen-2017-021290
    Copyright Statement
    © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
    Subject
    Clinical sciences
    Nursing not elsewhere classified
    Health services and systems
    Public health
    Other health sciences
    Publication URI
    http://hdl.handle.net/10072/377159
    Collection
    • Journal articles

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