1. Painful, Pointless and Potentially Infectious
Improving Perioperative IV catheter management
Philippa Ratcliffe RN M.A. CNS, PACU

2. The Problem
IV cannula inserted in the holding area were taped without using a Statlock® securement device requiring redressing in PACU
In PACU the tape was then removed, IV exposed to potential microbe infections, and redressed with Statlock® and Tegaderm ®

3. Problems Painful to patients
Risk of decannulation in the immediate post anesthetic period
Potential for infection

4. Reasons for habit-based technique
Common belief in the perioperative area that the existing Statlock® tubing was unable to deliver bolus fluids and medication

5. Good reason for a change
Introduction of evidence-based peripheral I.V. securement device with wide-bore Statlock® extension set
No financial implication to hospital
JCAHO and OSHA recommended hospital-wide

6. Benefits
IV cannula are secured from holding to PACU to final admission, reducing potential unscheduled IV restarts by up to 80%
Reduces the rates of potential phlebitis and overall complications by 67%
Frey, Anne Marie RN, BSN, CRNI(R); Schears, Gregory J. MD. Why Are We Stuck on Tape and Suture?: A Review of Catheter Securement Devices. Journal of Infusion Nursing. 29(1):34-38, January/February 2006.

7. Benefits
Improvement in staff safety by limiting exposure to blood and accidental needle stick injury
Increased patient satisfaction and reduction in patient stress
Reduction in time that cannula are open to airborne microbes

8. How we conducted change
Product extensively tested by David P Maguire, MD. Collaboration and cooperation from the anesthesiology department
Teaching sessions made available for CRNA’s, Residents and Attending Anesthesiologists in all affected OR areas
Posters in work area
Additional sessions for PACU staff to remain vigilant for missed Statlocks®

9. One year later…
% patients have an IV Statlock® in place on arrival to PACU – the remainder have had new IV’s started in the OR
Reduction in catheter and tape manipulation
Successful long term change of practice
Reduction in staff risk

10. Next Steps Aim for all Arterial lines to
have arterial Statlock® device
placed at point of insertion
Aim for all new IV’s inserted in the OR to have Statlock®
Continuation of education by ensuring new residents and staff are aware of practice and hospital policy