It was Professor Claire Rickard’s own motivation to be a “good nurse” that led her to investigate the best ways to care for patients with intravascular (IV) devices.
As a former medical, surgical, and ICU nurse, Claire found herself working at multiple hospitals across various specialities, yet all seemed to have conflicting policies around IV devices.
“I wanted to know the best practices,” Professor Rickard says.
“Should I change dressings daily or weekly?
“Should I use antiseptic or saline?
“There was enormous variation in policies, yet the problems across hospitals and specialities were the same.
“I had no postgraduate qualifications at that point, but I learned to read research papers and became a nurse researcher.”
Fast-forward 20 years and Professor Rickard now heads the Griffith-based Alliance for Vascular Access Teaching and Research (AVATAR) – the largest research group in the world looking at IV therapy and devices.
A key focus has been peripheral IV devices used extensively in hospitals and the community; devices which deliver medicines and fluids into the bloodstream. An estimated 15-20 million are used in Australia each year, but complications are reported in 25-50 per cent of devices.
“We’ve just completed a global research project entitled the One Million Global (OMG) Study with 41,000 patients across 51 countries throughout 416 hospitals, all of whom voluntarily participated because they understood a problem existed and needed to be addressed,” she says.
“We sometimes joke that our research doesn’t get headlines since we’re not curing cancer, but the irony is that even if tomorrow there was a cure for cancer, people couldn’t access it without some type of functional IV device – that’s where we come in.”
Results for OMG study worldwide
22% of dressings on IV devices were not clean, dry and intact
Risk of deadly bloodstream infection or device dislodging from the vein
69% of devices were not placed in the forearm veins
The hand or elbow have far higher complication rates
37% had no documented assessment within 24 hours
Invasive devices should be monitored every 8-12 hours
14% of devices were unused
Besides infection risk and discomfort, without use, blockage is common
10% had symptoms of complications (redness, pain, discharge)
Discomfort for patients, and risk of infection
Globally, nurses inserted 71% of IV devices. In Australia, this was just 26%.
Need for better training and expansion of nursing role within Australia.