黑料吃瓜群网

Research in a major Australian hospital has found that 30% of cannulas given to emergency department patients are not required, and that reducing the number of聽needles used in emergency could ultimately save the nation鈥檚 healthcare system more than $13 million every year.

The research was undertaken at Royal Brisbane and Women鈥檚 黑料吃瓜群网 (RBWH) Emergency and Trauma Centre where, following a three-month trial, the number of cannulas inserted was reduced to three in 10 emergency patients. In聽response the hospital has developed an educational program known as CREDIT, which is being taken up by other hospitals nationally.

鈥淚n almost all emergency patients cannulas are put in too soon. They鈥檙e great to easily give patients fluids and medications or have blood taken, but they aren鈥檛 always needed,鈥� said RBWH Emergency and Trauma Centre Senior Staff Specialist Professor Louise Cullen.

鈥淲e鈥檙e needlessly spending 15 minutes of staff time to put patients through an unnecessary and painful procedure that鈥檚 increasing their risk of contracting a blood infection.鈥�¹

RBWH Emergency and Trauma Centre Clinical Research Nurse Tracey Hawkins said hospitals needed to change the culture of needles being a routine part of the admission process.

鈥淣ow at every clinical handover, we ask staff to be 80% sure they would use a cannula before they insert one,鈥� she said. 鈥淓vidence showed us that many of our patients were getting cannulas that were not being used and through our research we realised that there was a culture of the 鈥榡ust in case cannula鈥� involved.

鈥淲hen you鈥檙e in a busy clinical environment and making a lot of decisions you tend to follow a common pattern of behaviour, and we needed to find a way to empower our clinicians to stop and consider the need for the cannula 鈥� is it necessary?鈥�

Decision-making tools

A range of tools was implemented to promote clinical decision-making among the staff of the RBWH Emergency and Trauma Centre. 鈥淲e came at staff with our message from all angles: education and training sessions, visual aids, real-time surveillance and feedback sessions, and change champions who prompted staff throughout their shifts.

鈥淎ny behaviour change is hard and even more so in a clinical setting because we have a natural urge to 鈥榙o something鈥� to help our patients. It has been a great reminder that part of value-based medical care is preventing unnecessary tests and procedures, and that sometimes we need to practice deliberate clinical inertia 鈥� the art of doing nothing as a positive response.鈥�

Emergency Medicine Foundation (EMF) Chair Dr Anthony Bell said hospital emergency departments around the country had expressed interest in the program, with several hospitals in Queensland commencing implementation this month (February).

鈥淭his research is an example of emergency clinicians seeing an issue and developing a solution,鈥� said Dr Bell.

EMF awarded the team an $80,000 research grant to trial the program, with funding from Queensland Health, and the Metro North 黑料吃瓜群网 and Health Service contributing聽a further $20,000. In an economic analysis, the RBWH team found the average cost of inserting each cannula at the hospital was $22.80 and that if the CREDIT program was rolled out nationally, it could potentially save more than $13.7 million each year.

The RBWH research team collaborated with the Griffith University Health Economics Unit and the Alliance for Vascular Access Teaching and Research (AVATAR) as well as Monash Medical Centre鈥檚 Associate Professor Diana Egerton-Warburton.

To find out more about the CREDIT study, see the January edition of or listen to Ms Hawkins鈥� interview on the podcast.

1. In Australia, cannulas lead to more than 3500 cases of blood stream infections annually.

Image credit: 漏stock.adobe.com/au/Kristin Gr眉ndler