Rachel O Connor1
1St John WA, Perth, Australia
Biography:
Rachel is a registered paramedic with 8 years of experience providing pre-hospital care. Her passion for patient safety and quality led her to transition into infection prevention and control in 2024.
Abstract:
Background
Vascular access devices (VADs) are widely used in the ambulance setting for the administration of fluids and medication for vital patient care. However, there are infection risks associated with the use of these devices. To guide quality improvement in Infection Prevention and Control (IPC) practices, the IPC Team undertook an audit of VAD use within St John WA (SJWA). The aim of this audit was to identify trends in VAD use and gain a baseline measure of unused VADs in the ambulance service.
Actions
The IPC Team undertook electronic case review to identify trends in VAD usage from 1st January 2019 to 1st November 2024. Several datasets were consolidated from the data, including case type (primary complaint), type of VAD (peripheral intravenous, intraosseous or external jugular), insertion site, success rates (including first attempt success rate) and unused device rates.
Results
Our audit identified over 205,000 insertion attempts during the audit period, with an average of 45,000 attempts per annum. An average success rate of 76% across all VAD types and an average unused rate of 32% was identified. Significant unused rate variation was identified on daily manual audit, with 55% on 1st November 2024 being the highest unused rate recorded during the audit period.
Conclusion
This comprehensive audit of VAD use in the ambulance setting identified several issues with vascular access insertion and documentation practices. The results of this audit will be used to guide quality improvement initiatives for practice and ultimately enhance patient care.