Awarded a $2.89 million grant from the MRFF, Professor Diana Egerton-Warburton OAM leads a major project to improve patient outcomes with education and thoughtful practices.
The Medical Research Future Fund (MRFF) has recognised Just Say No to the Just in Case Cannula: An Implementation Science Trial with Roadmap for National Roll Out with $2.89 million in funding assigned to the five-year project.
Through the MRFF, nearly 200 ground-breaking medical research projects will share in more than $382 million in grants.
The projects will help Australia’s outstanding medical researchers, including clinician researchers, discover new ways to diagnose, treat and care for people with various health conditions. They will also support early and mid-career researchers and give more Australians access to clinical trials.
Professor Egerton-Warburton said, “Peripheral intravenous catheters (PIVCs) can be painful to have inserted, take clinicians away from other care, and can have negative consequences on the health and wellbeing of patients. This is especially the case in hospital-acquired Staphylococcus aureus bacteraemia.”
The project is pragmatic, with the annual cost of PIVC insertion in Australian adult Emergency Department (ED) insertions estimated at $594 million, with the unused contribution being $305.9 million and taking an estimated 11,790 clinician days.
“The implementation project will provide immediate and increasing healthcare impacts using a stepped approach in participating health services. This will lead to a compelling policy context and pathway for applicability in a national scale-up.”
About the Project
“Persuading ED teams not to insert a painful PIVC that won’t be used is not ‘rocket science’, but it does take implementation science to achieve nationally,” explained Professor Egerton-Warburton
ED clinicians may insert a ‘just in case cannula’ in the belief that they are being safe, caring clinicians. However, up to half the cannulas inserted are not used for any treatment. The ultimate goal of the trial is to safely reduce cannula use in different types of EDs, reduce risks and costs, and improve patient care and experience.
The project will evaluate the intervention’s clinical, implementation and cost-effectiveness with four work packages. These include a controlled trial for the clinical effectiveness and safety of the intervention to reduce unnecessary PIVC insertion in ED patients by 10 per cent.
The study comprises nine diverse EDs and implements a package of interventions, three at a time, with six-monthly steps after a baseline measuring rates of PIVC insertion, use, safety and cannula-related infections.
This will be followed by an adaptive, co-designed, site-specific intervention development based upon our previous model using the COM-B system, Learning Health System and evaluated with the RE-AIM framework. The approach will involve stakeholder engagement, supported by a local clinical champion and researcher.
Within the trial, a cost-effectiveness analysis will calculate the net value of the intervention from the perspective of each hospital and funder. The cost of delivering the intervention, PIVC insertion and background health service use will be determined from trial data for the intervention.
The final stage is a roadmap for national scale-up with our partners including the Australian Commission for Safety and Quality in Healthcare and Colleges and will include implementation toolkits for diverse EDs, co-designed in the project’s last 12 months.
Approved by Associate Professor Anjali Dhulia, Chief Medical Officer, Executive Director, Medical Services