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Small change to IV lines yields big results

An innovative change to intravenous drip lines has seen rates of phlebitis – vein inflammation – in cardiology patients drop by almost half.

The brainchild of cardiology nurse Siobhan Seeney (image attached), the change followed an increase in phlebitis being noticed in patients.

“We decided to review the way we were administering amiodarone – a medication used to treat and prevent a number of types of irregular heartbeats, but which commonly causes vein inflammation,” said Siobhan.

“We examined the concentration of the doses being administered to patients, and the filtration size of the intravenous drip lines, and found two main issues – the intravenous drip lines didn’t meet international guidelines for concentration recommendations, and some vials of pharmacy-prepared amiodarone had visible precipitate.”

Precipitation appears as crystals or haziness inside the glass vial and, if present, means the drug should not be administered. The team found that the amount of precipitate was likely due to the unseasonably hot summer and the vials not being in fixed temperature storage during travel.

“As a result, we worked to ensure nurses on the ward, pharmacy and other areas were checking vials for precipitate. We then swapped all the intravenous drip lines for new ones that administered amiodarone through a smaller filter.

“The new drip lines are the same ones used for chemotherapy patients at Wellington Regional Hospital, meaning they are readily available, and using them didn’t require any major change in practice. This made for a swift, simple and cost-effective change that cut phlebitis by 40 percent in just a few months.

“In the past year since we’ve made the switch, phlebitis rates continue to be almost half of what we saw previously. It’s also reduced the length of stay, and reduced the need for antibiotics.”

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