Teleflex Incorporated · NYSE:TFX
Teleflex — Australian Vascular Access Society (AVA) Scientific Meeting 2015
26 slides from Teleflex's conference presentation, 2015
Slide 1: Evan Alexandrou presenter credentials
Evan Alexandrou RN MPH PhD Senior Lecturer School of Nursing and Midwifery – University of Western Sydney, Australia Clinical Nurse Consultant in Central Venous Access & Parenteral Nutrition - Liverpool Hospital, Australia Adjunct Senior Research Fellow, Alliance for Vascular Access Teaching and Res
Slide 2: Financial Disclosures
Financial Disclosures Please include the following information: 1. Disclosure of Relevant Financial Relationships I have the following financial relationships to disclose: Education Services for: Cook Medical Australia Angio Dynamics Australia Flo Medical Australia Teleflex Australia Unrestricted Gr
Slide 3: Background
Background • Over a billion PIVCs inserted annually in hospitalised patients • Most commonly practiced procedure in the clinical setting • Emergency admission / resuscitation • Blood sampling • Parenteral medication & fluid replacement • One of the most important innovations in health in the last 20
Slide 4: Background
Background • PIVCs are not without risk • Can contribute to hospital acquired infection • 1 infection for every 1000 PIVCs inserted – developed nations • 19 infections for every 1000 PIVCs - developing nations • Developing nations at greater risk • Re-use of needles, syringes and gloves • Less than
Slide 5: Background
Background • Despite PIVCs being so common… • Data on the use and management of PIVCs around the world is largely unknown • We do know from available literature: • Regions in China, Russia and India - steel needles still used instead of PIVCs • Localised complications remain an under reported proble
Slide 6: Background
Background We also know… • Zingg, Walter, & Pittet, Didier. (2009). Peripheral venous catheters: an under-evaluated problem. International journal of antimicrobial agents, 34, S38-S42.
Slide 7: Background
Background • Professional organisations / government bodies have best available evidence for us… • PIVC replacement • Dressing choice, replacement and management • Administration set replacement • IV fluid replacement • Flushing techniques • New evidence continually be updated
Slide 8: Background
Background • Yet….. • Phlebitis rates vary widely 1-60% • Catheter infiltration 6 – 34% • PIVC occlussion 3 – 33 % • PIVC dislodgement 4 – 10% • 1 – 19 infections for every 1000 PIVCs inserted • So what does this mean?? • Helm, Robert E, Klausner, Jeffrey D, Klemperer, John D, Flint, Lori M, & Huang
Slide 9: Background
Background • This means….. • Premature cessation of IV therapy • Re insertion of new PIVC • Time delay for treatment • Patient reported pain / anxiety • Increased length of hospital stay • Increased cost to facility • VENOUS DEPLETION (Vessel Health Compromised) • Helm, Robert E, Klausner, Jeffrey D
Slide 10: Background
Background • PIVC Failure is multifactorial: • Patient related – Co morbid conditions – Blood disorders – Venous depletion • Device related – Catheter material can be thrombogenic (especially where blood flow limited) – Catheter design to reduce traction and skin indentation – Securement / stabilisa
Slide 11: Background
Background • Why are these rates unacceptably high? • What is happening clinically in your hospital, your region, your country or globally? • What is being done better elsewhere that you can adapt? • We don’t really know because we have never really looked widely…..
Slide 12: OMG Study
OMG Study • International prevalence study • Targeting PIVC assessment & management Aims: • Identify prevalence of PIVCs in hospitalised patients worldwide • Evaluate prevalence of PIVC complications • Benchmark to improve care of PIVCs • Identify prevalence of redundant PIVCs • Identify practices i
Slide 13: OMG Study
OMG Study Significant interest worldwide: • 750 hospitals in 68 countries registered to participate • Largest prevalence study in vascular access • Hospitals from both developed and developing nations • Hospital collects data on as many patients as possible over a day to a week
Slide 14: OMG Study
OMG Study Pilot Study Completed November 2014: • Aim was to assess whether a larger study would provide beneficial data • We collected: • Demographics • PIVC dwell • PIVC type / brand / gauge • Where and who inserted PIVC • Anatomical position • Dressing type / brand / connectors • Site assessment •
Slide 15: OMG Study
OMG Study Pilot Study Completed November 2014: • Sites asked to collect as much data as possible on the day • Fourteen sites in 13 countries • Total 479 patients • 281 PIVCs audited (Overall prevalence of 59%) • Mean age 59 years (18) • More men than women • Predominantly medical patients • Prevalen
Slide 16: OMG Study
OMG Study TABLE 1. Number of Patients and Catheters Screened by Region and Country Pivc, Other No Total Region/Country n(%) VAD, n(%) IV, n (%) Patients, n Canada 1048) 1162) 0 a United States of America 16 4) 9(36) 0 5 Latin America ‘Agentina 50 69) 36) 10 (16) | 6 Westem Europe England 23 100) 0 0
Slide 17: OMG Pilot Study
OMG Pilot Study IV Fluid and Medication orders: Fiona Stanley Hospital, Australia
Slide 18: OMG US Study Data
OMG US Study Data Characteristics of US Hospitals Region West Midwest North East South Total Number of Hospitals 5 16 8 23 52 Number of PIVCs, n 573 1716 902 2144 4978 Age, mean (SD), y 58 (20) 59 (20) 61 (22) 60 (21) 60 (21) Males, n 256 (45) 820 (48) 460 (51) 853 (40) 2389 (48) Royal Devon and Exe
Slide 19: OMG US Study Data
OMG US Study Data PIVC Characteristics n, (%) 95% Confidence Interval PIVC inserted by, Specialist Team 550 (11) (10% - 12%) Nurse 3463 (70) (68 – 71%) Doctor 58 (1) (1% – 2%) Technician 161 (3) (3% - 4%) Unknown 570 (11) (11% - 12%) Prehospital / Other 167 (4) (3% - 4%) Where PIVC Inserted, Prehosp
Slide 20: OMG US Study Data
OMG US Study Data PIVC Characteristics n, (%) p Current IV Fluid Orders, Yes 2377 (49) No 2470 (51) Current IV Medication Order, Yes 1580 (31) No 3398 (68) <0.001 No IV or Fluid Orders, Yes 2027 (42) 95% Confidence Interval Dressing Type, Borderless Transparent 2778 (55) (56% - 60%) Bordered Dressin
Slide 21: OMG US Study Data
OMG US Study Data PIVC Characteristics n, (%) 95% Confidence Interval Dressing Quality, Clean and intact 3881 (80) (79% - 82%) Dry but soiled 334 (7) (6% - 8%) Loose or lifting 370 (8) (7% - 9%) Moist and soiled 139 (3) (2% - 3%) Symptoms of phlebitis, Nil 3990 (82) (82% - 83%) Pain 366 (7) (7% - 8%
Slide 22: OMG US Study Data
OMG US Study Data PIVC Characteristics n, (%) 95% Confidence Interval PIVC Position, Antecubital Fossa 1250 (26) (25% - 27%) Foot 37 (0.8) (1%) Forearm 1725 (35) (34% - 37%) Hand 1081 (22) (21% - 24%) Head 6 (0.1) (1%) Upper arm 151 (3) (3% - 4%) Wrist 521 (11) (10% - 12%) Catheter Gauge, 14G (Orang
Slide 23: OMG US Study Data
OMG US Study Data Symptoms of Phlebitis x Inserter Specialist Team Nurse Doctor Technician p Symptoms of Phlebitis, Nil 455 (85) 2807 (84) 47 (82) 123 (76) <0.001 Pain 48 (9) 254 (7) 4 (7) 10 (6) Redness 23 (4) 81 (2) 0 2 (1) Swelling 8 (1) 46 (1) 1 (2) 4 (2) Purulence 0 4 (0.1) 0 0
Slide 24: OMG US Study Data
OMG US Study Data Who has submitted data? • Over 400 hospitals have submitted data so far • Representing 50 countries • Over 3000 wards screened • So far….40,000 PIVCs audited globally • Estimated 65,000 patients screened • Still more data to be entered! Greenville memorial Hospital, South Carolina
Slide 25: ASWASM 2016
Ne ASWASM 2016 Intravascular Line Savers are Life Savers Hosted by the Australian Vascular Access Society you are invited to attend the 1%* Vascular Access Scientific Meeting 29 - 30 April 2016 Brisbane Convention and Exhibition Centre Queensland, Australia Bier Join the conference mail list: is htt
Slide 26: Record Session ID and CE Code
*******IMPORTANT******* Record the Session ID and CE Code below to earn Continuing Education credit! SESSION ID: CE CODE: __________ __________
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