Quality & Safety Corner SABSI What is a SABSI and how does it harm our patients?
A SABSI, or Staphylococcus Aureus Bloodstream Infection, is a significant health care associated complication which can result in significant harm to a patient. It can also lead to an increased length of stay while a patient completes a course of antibiotic therapy. At Ryde Hospital we have recently undertaken several SABSI investigation to better understand how these infections are occurring, and importantly what we can do to prevent future infections. A feature of all these investigations has been the overall poor documentation of PIVC (Peripheral Intravenous Cannula) insertion and maintenance. There are significant gaps in the documentation recorded from lack of details around what and when PIVCs are inserted, to who they are inserted by and if aseptic technique is used. There is also a consistent lack of clarity around where the PVC is situated with a recent investigation finding that the same PIVC was variously described as placed in the wrist, hand and arm!
Other important information is also not being documented, especially around the need for a PIVC to be maintained which should be documented daily by the medical team. Keeping a PIVC in-situ that is not needed significantly increases the risk of harm to a patient. VIP (Visual Infusion Phlebitis) scores should be determined on each nursing shift. These scores, ranging from 0-5, help assess the patency of the PIVC by monitoring for phlebitis. If a score of 2 or more is given the PIVC should be removed. See table below for more information on how to assess a VIP score. The length of time a PIVC should remain in-situ should generally not exceed 72 hours, and documentation of removal of a cannula is also an important component of the health care record. For more information on placing and maintain PIVCs please review the NSLHD Adult Peripheral Intravenous Cannula Insertion and Management Procedure or to refresh your knowledge on this important clinical skills view the RNSH video using the following link Cannulation - RNS on Vimeo
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