2. Implementation in practice
Evaluation of a trial of two safety engineered iv cannulae
Setting:
Acute London hospital theatres dept
May/June 2007

3. Background MCEAG Finance Costs it can be introduced at no extra cost
savings of about £5649 (rebate of £0.20 per cannulae available) estimated

4. Products evaluated Ported, winged cannula (20, 22 & 24G)
Non-ported, non winged cannula (14,16,18, 20, 22 & 24G)
incorporate self-activating clip technology, preventing needlestick injury

5. Ported, winged cannula

6. Non-ported, non winged cannula

7. Evaluation Plan Two week trial Evaluation form Covering letter
Theatres
Emergency
Neurosurgery
Liver
Urology
Standard cannulae removed during trial

8. Coordinated by: Supplies Clinical Nurse Advisor
Consultant in Occupational Medicine
Consultant Anaesthetist
Principal ODA, Theatres
Theatre Manager
Infection Control Lead Nurse
Practice Development Lead Nurse

9. Evaluation criteria Ease of use/requirement for training Dexterity
Sharpness
Flashback visualisation
Patient experience
Reliable operation of safety mechanism
Sharps injury risk reduction (perception)

10. This product requires to user to change cannulation technique

11. The safety device is easy to use

12. The safety feature requires more time to use than the standard non-safety device

13. This device required more manual dexterity than a standard device

14. This device was sharp and penetrated easily

15. This device allowed rapid visualisation of flashback in the cannula or chamber

16. Use of this device does not increase the number of attempts to cannulate

17. The use of device does not increase pain and trauma for patients

18. It is easy to stop the flow of blood and attach connections with this device

19. It is clear (audible or visual) when the safety device has been activated

20. The safety feature operates reliably

21. The product does not need extensive training to operate reliably

22. The device is easily secured to the patient

23. Do you think this device will help prevent needlestick injuries?

24. Have you sustained a needlestick injury while using the device?

25. How many times did you use the device before you felt comfortable with it?

26. Conclusions
the two devices were well received and acceptable to users on all parameters

27. Recommendations
Ported, winged cannula (20, 22, & 24G) to be implemented only in the Theatres
Non-ported, non winged cannula (14, 16, 18, 20, 22, & 24G) to be implemented throughout the Trust

28. Implementation August 2007 Briefing letter for ward and departments
Training sessions e.g. for new junior doctors

29. October 2007 6 week post implementation
Majority of wards and departments had slowly started to use the smaller gauges of the non-ported, non-winged safety cannula
Large amount of old stock, especially the larger gauge sizes (18, 16 & 14G)
These sizes are infrequently used on the wards, so it will take considerable time for stock to be moved and replaced by the non-ported, non-winged safety cannula

30. October 2007, surgical ward
Ward had a large amount of stock of old ported product– sizes 18 & 20G.
When questioned they said that they “had been using this cannula for a while”.

31. October 2007, paediatric wards
These wards had stock of a 24G IV cannulae and which were non-safety.
They did not appear to have the non-ported, non-winged cannula yet.
Codes needed changing

32. October 2007, ITU
Had stock of old IV cannulae and non- safety cannulae
They had 2 boxes of the non-ported, non-winged safety cannulae only.

33. October 2007, neonatal unit
Would like to continue evaluating the non-ported, non-winged safety cannula.
This is being coordinated by Matron
They are currently successfully using the samples and Matron has said that the SHOs are now evaluating them.
Evaluation is slow as they do not use many IV cannulae.

34. October 2007, main theatres
Principal ODA said that the non-ported, non-winged cannulae were being ordered and slowly used, however old stock was being ordered incorrectly.
Consultant Anaesthetist said that the anaesthetists are slowly getting used to the difference.
A lunch meeting with the anaesthetists planned for 30th October to discuss the use of the non-ported, non-winged cannulae

35. October 2007, planned investigation and treatment unit and midwifery
Matron and Practice Development Nurse to co-ordinate a cannulation training programme for nurses and midwives

36. Implementation planning
Groundwork, stakeholders
Business case
Trial/pilot
Training
Evaluate
Feedback, information
Monitor, evaluate, review