• Tracey Hawkins, Jaimi H Greenslade, Jessica Suna, Julian Williams, Claire M Rickard, Matthew Jensen, Maria Donohue, Elizabeth Cho, Hise Christopher Van CV School of Medicine, University of Queensland, Herston, Queensland, Australia., Diana Egerton-Warburton, and Louise Cullen.
• Department of Emergency Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
• Acad Emerg Med. 2018 Jan 1; 25 (1): 26-32.

ObjectivesThe objective was to examine cannulation practice and effectiveness of a multimodal intervention to reduce peripheral intravenous cannula (PIVC) insertion in emergency department (ED) patients.MethodsA prospective before and after study and cost analysis was conducted at a single tertiary ED in Australia. Data were collected 24 hours a day for 2 weeks pre- and post implementation of a multimodal intervention. PIVC placement and utilization within 24 hours were evaluated in all eligible patients.ResultsA total of 4,173 participants were included in the analysis. PIVCs were placed in 42.1% of patients' pre intervention and 32.4% post intervention, a reduction of 9.8% (95% confidence interval [CI] = 6.8 to -12.72%). PIVC usage within 24 hours of admission was 70.5% pre intervention and 83.4% post intervention, an increase of 12.9% (95% CI = 8.8% to 17.0%). Sixty-six patients were observed in the ED for cost analysis. The mean time per PIVC insertion was 15.3 (95% CI = 12.6 to 17.9) minutes. PIVC insertion cost, including staff time and consumables per participant, was A$22.79 (95% CI = A$19.35 to A$26.23).ConclusionsThe intervention reduced PIVC placement in the ED and increased the percentage of PIVCs placed that were used. This program benefits patients and health services alike, with potential for large cost savings.© 2017 by the Society for Academic Emergency Medicine.

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