Griffith University has received $1.5 million in funding from the National Health and Medical Research Council, and matched support from national and state health partners ($2.1 million), to improve the experience for thousands who require peripheral intravenous (IV) catheters.
Griffith researchers will work with three Queensland partner hospitals (two metropolitan and one regional), the Queensland rural and remote education provider, and the Australian Commission on Safety and Quality in Health Care on the project.
“Peripheral intravenous catheters (IVs), inserted into a patient’s hand or arm, are the most commonly used device in hospitals around the world and their placement can be difficult, painful and time-consuming,” says Professor Claire Rickard who leads Griffith’s Alliance for Vascular Access Teaching and Research.
“We often need multiple attempts to insert IVs, with some patients having to experience 10 or more attempts (needle punctures) or the procedure is abandoned which delays important treatments such as antibiotics.”
“Obesity, advanced age, conditions like cancer, and damage from previous IV insertion attempts, make the insertion procedure more difficult than usual.”
Professor Rickard said while international guidelines recommended ultrasound-guided IVs as the first approach for patients with difficult IV access, their use in Australia was negligible.
“Ultrasound guidance allows us to visualise the vessel beneath the skin and follow the needle tip as it is inserted into the vessel. It improves success rates and decreases complications and pain.” she said.
“This project will help thousands of people who experience problems having an IV inserted, including premature babies, the aged and those in rural and remote settings without access to advanced practitioners.”
Once the difficult IV access ultrasound pathway has been designed it will be progressively trialled across hospitals before a national rollout in metropolitan and rural and remote settings.
Gold Coast University Hospital emergency physician Professor Gerben Keijzers said the funding will greatly improve the experience for patients requiring IV catheters.
“This collaboration will be important to avoid unnecessary pain for patients by training more staff to be skilled in ultrasound for IV insertions” he said.
Tricia Kleidon, Paediatric Vascular Access Nurse Practitioner at Queensland Children’s Hospital, said the project was a game-changer for some of their most vulnerable patients.
“It will provide clinicians with much-needed resources including clinical decision-making tools, education and training as well as an escalation pathway for clinicians to follow.
“This means when a child is identified with difficult IV access, they will be immediately escalated to a clinician skilled in difficult intravenous access, avoiding the pain and anxiety associated with multiple failed vascular access attempts.”
For Royal Brisbane and Women’s Hospital Nursing and Midwifery Director, Research Dr Nicole Marsh, the project is perfectly timed.
“Ultrasound-guided placement of peripheral intravenous catheters has been highlighted as a priority area for Royal Brisbane and Women’s Hospital,” Dr Marsh said.
“We are confident this innovative project will lead the way for healthcare improvement across Australia.”
This research into ultrasound-guided placement of IV catheters aligns with work being done by the Australian Commission on Safety and Quality in Health Care to improve the experience of patients having an IV inserted.
“Ultrasound has the potential to reduce the number of painful IV insertions experienced by some patients in Australian hospitals,” said Commission Chief Medical Officer Dr Robert Herkes. “The Commission is currently developing a Peripheral Venous Access Clinical Care Standard to support health services use best practice for IV insertion.”