Kingsway CEDC Sept 2009 Educational Intervention Cannulation Update 2009 To increase the appropriateness and technique of intravenous cannulation.

Kingsway CEDC Sept 2009 Background DOH initiative to reduce hospital acquired infections. No evidence that pre-hospital cannulation leads to a higher risk Educational intervention will bring about a positive change in attitude, practice and technique Reducing unnecessary cannulation and improving the use of infection control techniques A clinical audit on the rate and appropriateness of cannulation across EMAS divisions is now available on Insite.

Kingsway CEDC Sept 2009 Objectives Revision of indications for cannulation Revision of the non-touch procedure Revision of the care elements Revision of aseptic techniques Revision of hand hygiene Revision of use of gloves

Kingsway CEDC Sept 2009 Indications for Cannulation jrcalc 2006 Cannula should be inserted: If the patient needs fluid replacement If the patient needs IV medication If the patient’s condition requires it Cannula should not be inserted: Because the admitting hospital staff expect it To retain skills/practice

Kingsway CEDC Sept 2009 Non-Touch Procedure Explain the procedure to the patient Prepare equipment Preparation of clinician hands Prepare patient Cannulation Procedure Disposal of sharps Recording Key Themes

Kingsway CEDC Sept 2009 Care Elements Hand hygiene Personal protective equipment Skin preparation Dressing Cannula access Documentation

Kingsway CEDC Sept 2009 Principles of Aseptic Techniques keep exposure of a susceptible site to a minimum ensure hand decontamination prior to the procedure use gloves depending on nature of susceptible site ensure all fluids and materials used are sterile check sterile packs for evidence of damage or moisture penetration ensuring contaminated/non- sterile items are not placed in the sterile field. to not re-use single-use items reduce activity (where possible) in the immediate vicinity of the area of the procedure

Kingsway CEDC Sept 2009 Hand Hygiene HAND WASH On soiled hands After using the toilet Before eating If near a sink On removing soiled gloves ALCOHOL RUB On visibly clean hands After hand washing On entering and leaving clinical areas

Kingsway CEDC Sept 2009 Use of Gloves Gloves should only be worn if - Discuss Gloves should: –Be donned immediately before pt. care –Be changed between each pt. task –Be changed between caring for different patients. –Be removed and discarded as clinical waste. Gloves should NOT be worn - Discuss

Kingsway CEDC Sept 2009 References Joint Royal Colleges Ambulance Liaison Committee, Ambulance Service Association. UK Ambulance Service Clinical Practice Guidelines. London: Ambulance Service Association,2006. Siriwardena N, Iqbal M, Banerjee S, Spaight A and Stephenson J (Dec 2008). An evaluation of an educational intervention to improve technique and appropriateness of intravenous cannulation by ambulance paramedics in the East Midlands. EMAS NHS Trust. East Midlands Ambulance Service NHS Trust. Infection Control Operational Procedures