Presentation (CTI)

OBJECTIVES: Majority of inpatients require an intravenous cannula during their hospital stay. Multiple studies demonstrated that adopting a closed integrated peripheral intravenous cannula (PIVC) system protects veins longer and reduces the risk of complications. This study assessed the annual clinical and economic impact of adopting a closed integrated PIVC system, when compared with a non-integrated system, for inpatients in an Australian hospital.
METHODS: A budget impact model was developed in MS Excel to analyze the clinical and economic impact from hospital perspective. Analysis was based on a 500-bed hospital with 85% occupancy rate over one-year period, average length of stay was 5.4 days, with 70% of inpatients requiring PIVC. The hospital adopts a 72-hour cannula replacement protocol. Published studies were referenced for inputs such as cannula failure rate while the consumables and complication management costs were informed by local data. Outcomes evaluated include consumables utilisation, dislodgement, cannula failure, nurse time, and cost impact.
RESULTS: The model estimated 20,123 inpatients requiring PIVC annually. Adopting the closed integrated PIVC system reduced the annual number of PIVCs by 8.4% (4,730) due to fewer insertion attempts. Dislodgement episodes decreased by 26% (673), cannula failure episodes reduced by 18% (1,268), and nurse hours decreased by 8.4% (1,207). The estimated reduction in dislodgement and cannula failure saved AU$8,898. Improved operational efficiency saved AU$67,208 of nurse time. These offset the increase in consumable costs of AU$1,648, resulting in an overall annual cost savings of AU$74,458 (6.5%). When the hospital adopted a 144-hour clinically indicated cannula replacement protocol, the estimated annual cost savings increased to AU$540,502 (47.4%).
CONCLUSIONS: Less clinical complications and improved operational efficiency can be expected with a closed integrated PIVC system, leading to better patient outcomes and more efficient use of nurses’ time with less time spent on complication management. These benefits can result in potential overall cost savings.