The Process and Outcomes of Peripheral Venous Cannulation in a Tertiary Care Center: a Prospective Completed Audit Loop Study

Abstract

Peripheral venous cannulations are one of the most common procedures carried out in today’s healthcare setting. It is an invasive procedure and carries with it the risk of bloodstream infections. There are guidelines for insertion and management of peripheral venous cannulas. One such guideline is the standards of infusion therapy from the Royal College of Nursing. In this study, we aim to assess the process and outcomes of peripheral venous cannulation in our institution against these guidelines. We conducted a prospective completed audit loop study on the process and outcomes of peripheral venous cannulation in our institution. The preliminary audit was conducted in the month of December 2019. The staff were trained on various aspects of cannulation based on the guidelines in the following month. A reaudit was conducted between May and August 2020, and the data were analyzed. A total of 362 cannulations were audited for the study. Forty-seven cannulations were observed during the initial audit, and 315 cannulations were included for the reaudit. On comparative analysis, there was a statistically significant improvement in hand hygiene, use of gloves, appropriate site selection, flushing of the cannula, and documentation in the reaudit in comparison with the initial audit. There was also a statistically significant reduction in the number of recannulations. Peripheral intravenous cannulation although a simple procedure can cause significant morbidity if not performed properly. Auditing such procedures shows deficiencies in performance. Reaudit, after adequate retraining of staff, shows significant improvement in performance and outcome.