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dc.contributor.authorMarsh, N
dc.contributor.authorLarsen, E
dc.contributor.authorHewer, B
dc.contributor.authorMonteagle, E
dc.contributor.authorWare, RS
dc.contributor.authorSchults, J
dc.contributor.authorRickard, CM
dc.date.accessioned2021-04-14T23:28:31Z
dc.date.available2021-04-14T23:28:31Z
dc.date.issued2021
dc.identifier.issn2468-0451
dc.identifier.doi10.1016/j.idh.2021.03.001
dc.identifier.urihttp://hdl.handle.net/10072/403672
dc.description.abstractBackground: Peripheral intravenous catheters (PIVCs) are medical devices used to administer intravenous therapy but can be complicated by soft tissue or bloodstream infection. Monitoring PIVC safety and quality through clinical auditing supports quality infection prevention however is labour intensive. We sought to determine the optimal patient ‘number’ for clinical audits to inform evidence-based surveillance. Methods: We studied a dataset of cross-sectional PIVC clinical audits collected over five years (2015–2019) in a large Australian metropolitan hospital. Audits included adult medical, surgical, women's, cancer, emergency and critical care patients, with audit sizes of 69–220 PIVCs. The primary outcome was PIVC complications for one or more patient reported symptom/auditor observed sign of infection or other complications. Complication prevalence and 95% confidence interval (CI) were calculated. We modelled scenarios of low (10%), medium (20%) and high (50%) prevalence estimates against audit sizes of 20, 50, 100, 150, 200, 250, and 300. This was used to develop a decision-making tool to guide audit size. Results: Of 2274 PIVCs evaluated, 475 (21%) had a complication. Complication prevalence per round varied from 7.8% (95% CI, 4.2–12.9) to 39% (95% CI, 32.0–46.4). Precision improved with larger audit size and lower complication rates. However, precision was not meaningfully improved by auditing >150 patients at a complication rate of 20% (95% CI 13.9%–27.3%), nor >200 patients at a complication rate of 50% (95% CI 42.9%–57.1%). Conclusion: Audit sizes should be 100 to 250 PIVCs per audit round depending on complication prevalence.
dc.description.peerreviewedYes
dc.languageeng
dc.publisherElsevier BV
dc.relation.ispartofjournalInfection, Disease & Health
dc.subject.fieldofresearchHealth services and systems
dc.subject.fieldofresearchPublic health
dc.subject.fieldofresearchcode4203
dc.subject.fieldofresearchcode4206
dc.subject.keywordsAudit
dc.subject.keywordsClinical indicators
dc.subject.keywordsInfection
dc.subject.keywordsPeripheral intravenous catheter
dc.subject.keywordsQuality measurement
dc.title‘How many audits do you really need?’: Learnings from 5-years of peripheral intravenous catheter audits
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationMarsh, N; Larsen, E; Hewer, B; Monteagle, E; Ware, RS; Schults, J; Rickard, CM, ‘How many audits do you really need?’: Learnings from 5-years of peripheral intravenous catheter audits, Infection, Disease & Health, 2021
dcterms.dateAccepted2021-03-03
dcterms.licensehttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.date.updated2021-04-13T00:28:02Z
dc.description.versionAccepted Manuscript (AM)
gro.description.notepublicThis publication has been entered in Griffith Research Online as an advanced online version.
gro.rights.copyright© 2021 Australasian College for Infection Prevention and Control. Published by Elsevier B.V. All rights reserved. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.
gro.hasfulltextFull Text
gro.griffith.authorLarsen, Emily N.
gro.griffith.authorSchults, Jessica
gro.griffith.authorWare, Robert


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