Effect of PRIME Project on the prevention of infection and errors in intravenous treatment

 Y.A.Cho, RN1, J.A.Shin, RN1, J.Y. Jung, RN1

1QI team, INHA university Hospital, Incheon, South korea

 

Introduction(Background)

Medication administration is one of the most tasks of nursing work and nurses are not only in charge of the overall medication administration process but also play a key role in to prevent medication errors as performers who finally deliver drugs to patients. More than 85% of inpatients are receiving various intravenous injections. However, intravenous injection therapy can cause various complications such as systemic infection with increased body temperature, varicose inflammation such as infiltration and blood at the injection site, air embolism, nerve damage, and abnormal location of the venous tube, so careful management should be carried out during the treatment. In addition, medication errors account for 31.8% of the total patient safety accidents, and drug preparation, incorrect dosage, and inappropriate administration are the causes. Accordingly, this study aims to prevent complications and administration errors related to intravenous injection and contribute to improving the patient safety culture by applying a detailed clinical practice guidance program to support nurses' medication work during intravenous therapy.

 

objectives

The purpose of this study was ensuring patient safety by applying a safety injection practical project for nurses to prevent complications and medication errors and support clinical practice in intravenous(IV) infusion therapy.

 

Hypothesis

We have established three hypothesis as follows.

 

1. The compliance rate of clinical practice for safe injections will improve compared to before PRIME project implementation.

2. Medication error occurrence rate will be reduced compared to before PRIME project implementation.

3. Central vein complication rate will decrease compared to before PRIME project implementation.

 

Methods

Developed and named PRIME(Preventing Risks of Infections and Medication Errors in IV infusion Therapy) program for evidence based safe injection clinical practice to encourage unit-based activity. PRIME program consisted of Team organization and teaching, evaluation and monitoring, result analysis and action plan implementation and applied Plan-Do-Study-Act(PDCA) tool. PRIME program was applied from June 2019 to November 2019 to four medical-surgical units. Evaluation and compliance rate was monitored and analyzed every month.

Research tool used by modifying and supplementing clinical practice checklist for safe injections provided by PRIME program.

General matters were analyzed as real numbers and percentages, and tests of hypothesis were compared and analyzed by using t-test and Wilcoxon signed rank test.

 

Conclusion

The PRIME project was drawn unit-based activity through standardizing evidence based safe injection clinical practice from conventional practice. As a result, it improved nurses’ competency and practice of patient safety and quality improvement