Becton, Dickinson and Company · NYSE:BDX
Becton, Dickinson and — MDS20 EU (April 2020)
24 slides from Becton, Dickinson and's conference presentation, April 2020
Slide 1: Presenter views disclaimer
These presentations were developed by the respective presenter(s), and the findings, interpretations, and conclusions contained or expressed with them do not necessarily reflect the views of BD. To the extent these presentations relate to specific products, such products should always be used in acc
Slide 2: Reflections on leading an IV team: Strategies and Impact
Reflections on leading an IV team : Strategies and Impact Jennifer Caguioa Lead IV Practitioner Kings College Hospital NHS FT, London, UK
Slide 3: Our IV Team Story
Our IV Team Story • Where? • Why? • What? • How? Our 4 Strategies • The Impact • Conclusion
Slide 4: Where? King's College Hospital NHS Foundation Trust
Where? King’s College Hospital NHS Foundation Trust 1,500 + beds Jointly we train 900 dentists, 300 nurses and 750 doctors every year 3
Slide 5: 2009: Where do we begin?
2009: Where do we begin?
Slide 6: Why?
Why? “Guidelines alone will not do the job” Pratt, June 2010 2010-2011
Slide 7: Themes to address: 2009-2010
Themes to address: 2009-2010 • Non-availability and lack of standardisation of IV equipment • Poor IV documentation and variable compliance to standards • Need for clinical engagement
Slide 8: From this ...
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Slide 9: To this ...
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Slide 10: How?
How? Themes 2009 Strategies • Lack of standardised IV Standardisation equipment and practice- i.e. adherence to infection control measures, aseptic technique • Poor IV documentation and Staff training and compliance to basic standards education • The need for IV and IC Sustaining engagement Champion
Slide 11: Project H.A.N.D.S.
Project HANDS Strategy: Care Bundling + Training+ Collaborative working EVIDENCE BASED COMPONENT WHAT WE DID? Project Hand Hygiene H.A.N.D.S. • Identify IC champions-Medical & Nursing H • Work with Infection Control team • Work with Procurement Antisepsis with 2% A chlorhexidine • Reinforce skin ant
Slide 12: The Impact
The Impact The IV team … • Improved patient safety and IV care • Heightened awareness of the basics of IV insertion and care • Engaged clinical staff to comply with IV standards • Helped reduce MRSA IV catheter related blood stream infections
Slide 13: The Results on IV related MRSA
The Results on IV related MRSA 20 18 16 Denmark Hill 14 12 10 8 total MRSA bacteraemia cases 6 4 IV line related bacteraemia cases 2 0 3.5 3 PRUH 2.5 2 1.5 total MRSA bacteraemia 1 cases 0.5 IV line related bacteraemia cases 0 2013 2014- 2015- 2016- 2017- 2018-2019 -2014 2015 2016 2017 2018
Slide 14: Themes to address: 2012 onwards
Themes to address :2012 onwards • Evolving IV Team to an IV Access Team • Develop more IV link nurses locally • Strengthen links and work with community and external organisations
Slide 15: Hard-wiring best practices
HARD-WIRING BEST PRACTICES How can we maintain best practice? (Harpel, 2013) 1. Read journals to know the current, expert recommendations (CDC, Infusion Nurses Society [INS], Saving Lives). 2. Join professional nursing associations, such as NIVAS, INS, AVA 3. Review new products and trial products,
Slide 16: The Results: our IV scorecard data
The Results : our IV scorecard data DH - odd months PRUH- even months
Slide 17: Project HANDS continued
Project HANDS continued Themes Strategies 2009 - Standardisation Lack of standardised IV equipment and practice- i.e. adherence to infection control measures, aseptic technique Poor IV documentation and Staff training and education compliance to basic standards The need for IV and IC Champions Susta
Slide 18: Cannulas before a PICC!
31 cannula’s before a PICC! Orders: IV Lines Status: Al Pd = BTS Pink 20a) Leh Hard 1a Rowe on 30 Sap Sa a S237 Pink ig) Hight Hand a SOE aoa wt 1959 Gowen (Gal ba Nand TSE S7, Observe tor Inve mipiaiion BSep 14 15.05 BPoeri4 oe a0 Fon so wre TOA S ala 1a ae a Pergheial Venous Access Ob: Stat Observ
Slide 19: Nature of IV access required
King’s College Hospital Nature of IV access required NHS Foundation Trust 2222 Escalate in this order 1. Within Clinical Team 2. 1V Team (Mon-Fri 0900-1700) 3. Hospital @ Night (out of hours 1930-0800) 4. Anaesthetics 5. iMebile (out of Hours only) Emergency Non-emergency if peripheral IV access if
Slide 20: The perfect cannula: save the line, save the vein
THE PERFECT CANNULA SAVE THE LINE, ite visible, SAVE THE VEIN. strips Routine IV device replacement is correctly no longer best practice (Rickard 2012; Loveday et al, 2014; RCN 2017) EVEN IF IT’S 3 DAYS OLD, IF: ATENT LINE IP SCORE =0 LINICALLY NEEDED KEEP THE CANNULA IN. Any Questions? Please conta
Slide 21: The benefit of having PVC orders on EPR
The benefit of having PVC orders on EPR DH 2017 DH 2018 [TOTAL NO OF CANNULAS site \gauge pink 20 blue 22 16613) 121 orange 14 1022 869) green 18 812 7521 igray 16 6253} 6152) yellow 24 385 281 attempts once twice 5956] 3717 more than 2x 1139 823 lunknown 22377 20570 vein quality excellent 15709 122
Slide 22: Conclusion
Conclusion: Our strategies have been effective in our context and the IV service has a positive impact on patient care, on standards and on the organisation. Our current IV team model is effective but needs to respond to the changing needs of the organisation. 2009 present
Slide 23: Thank you, Any Questions?
Thank you Any Questions? jennifer.caguioa@nhs.net
Slide 24: Further reading
Further reading… • Barritt, E.R. (1975). Florence Nightingale: Her wit and wisdom. Mount Vernon, NY: Peter Pauper Press • Caguioa, J. et al., ( 2012) H.A.N.D.S. : Standardised Intravascular Practice based on Evidence. British Journal of Nursing (IV Therapy Supplement) 21 (14): S4-S11. • Caguioa, J.
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