Authors (including presenting author) :
Wong CN(1), Chan SC(1), Lam I(4), Lo YM(2), Leung HM(3), Ng ML(1), Chan MK(1), Chow CM(2), Kwong PS(4), Pang SK(3), Ng LK(1)(2)(3)(4)
Affiliation :
(1) Department of Surgery, (2) Department of Orthopedics and Traumatology, (3) Electro-medical Diagnostic Unit, (4)Operation Theatre
Introduction :
Peripheral intravenous catheter (PIVC) is common in clinical practices for giving medication injections and infusions. Proper disinfection before access is vital to prevent catheter associated infection. Although disinfections of connectors are common in day to day practices, there are still lack of consensus on the optimal disinfection time of the needleless connectors. Recent meta-analysis suggested that scrubbing the connector with 70% alcohol for 5 seconds is able to obtain adequate disinfection. Staff compliances on disinfection of needleless connector and knowledge related to PIVC care are also critical to prevent PIVC associated complications. The aim of the project is to promote the latest, evidence based disinfection technique to all nursing staff and improving staff knowledge as well as compliance on PIVC related care.
Objectives :
1. To promote the latest, evidence based disinfection techniques of needleless connectors for peripheral intravenous catheter (e.g. scrub the hub with 70% alcohol or chlorhexidine in alcohol for 5 seconds) to the colleagues in surgical department.
2. To improve staff compliance on disinfection of needleless connectors within real practical situation.
3. To enhance staff knowledge on care of PIVC and related complications
Methodology :
A cross departmental program was piloted in RTSKH between 2/2019 and 1/2020. A total of 74 nursing staff were involved in the program. The objective of the project was achieved through education to the frontline staff on PIVC related care. A standardized education material was developed as a medium to provided up to date disinfection techniques to the colleagues. Staff knowledge on PIVC care, staff compliance on the disinfection techniques and data related to PIVC associated infection would be reviewed before and after the education to measure the outcome of the project.
Staff knowledge on PIVC care was reviewed through a questionnaire consisted of 5 questions. Staff compliance on disinfection technique of needleless connector would be reviewed through spot check of disinfection time before and after the intervention in the corresponding unit. Rate of PIVC associated phlebitis would be assessed through counting the frequency of phlebitis observed in a 4-week observation period before and after the intervention.
Result & Outcome :
Improvements were observed in staff compliance on disinfection of needleless connector and staff knowledge on PIVC care. Percentage of staff who would scrub the hub for more than or equal to 5 seconds had been improved from 18% to over 80%. The mean scores of the questionnaire had been improved from 1.93/6 to 4.32/6. The observed frequency of phlebitis decreased from 1 to 0 after the intervention but the changes were not significant.
Conclusion
Standardized education to frontline nursing staff and ongoing evaluation is effective in maintaining staff knowledge in PIVC care and compliances in disinfection of needleless connectors. Current data is inadequate to give further prove of the suggested disinfection duration in adequacy of disinfection of needleless connector and ongoing monitoring is necessary.
