‘Spectacular result’ for clinician-led quality improvement project

NEWS - eHealthNews.nz editor Rebecca McBeth

The introduction of clinician-designed, electronic forms into nurses’ existing electronic workflow at Christchurch Hospital increased documentation of IV-line insertion from 32 to 85 percent.

Leah Wilkins, Te Whatu Ora Waitaha Canterbury clinical nurse specialist, infection prevention and control service, says international evidence shows documentation of peripheral intravenous catheters (PIVC) insertion and management is generally poor globally, and especially in Australia and New Zealand.

A quality improvement project saw the introduction of PIVC documentation into Christchurch Hospital’s shared electronic notes system Cortex.

Wilkins, who will be presenting on the project at Digital Health Week in Rotorua this December, says its success shows improved electronic documentation can be achieved despite high workloads and resource constraints.

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Becky Hickmott, executive director of nursing for Waitaha Canterbury, says infections in these IV lines are costly to both patients and health systems so accurate documentation is vital to safe patient care.

However, documenting their insertion and monitoring had not been effectively integrated into regularly used nursing electronic documents, when there was a shift from paper-based records to electronic documentation.

She says two clinical nurse specialists were trained as Cortex designers and worked on the electronic forms, which went live in May 2022 and have increased documentation of PIVC insertion from 32 up to 85 percent.

An audit also revealed that of the 154 PIVC observed, 89 percent had documented assessment of the patient’s visual infusion phlebitis (VIP) score, up from 19 percent.

“That’s a pretty spectacular result,” says Hickmott.

“And this happened at a time when we were facing some of our most challenging workloads ever, with significant staffing challenges and severe over capacity.

“To still achieve those results confirms that when you integrate the electronic documentation process in the natural workflow, it really drives positive change and supports policy adherence and patient safety.”

Picture: Leah Wilkins, clinical nurse specialist in the infection prevention and control service, will be presenting at Digital Health Week.

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