Inform and partner with patients

Quality statement 2

A patient requiring intravenous access receives information and education about their need for the device and the procedure. Their consent is obtained and they are advised on their role in reducing the risk of device-related complications.

Purpose

To ensure that, when clinically possible, a patient is given information about their need for IV access and the procedures associated with inserting, maintaining and removing a PIVC. This is so patients can consider the risks and benefits, and make a decision about whether it is right for them. Patients also have the opportunity to ask questions so that they can be engaged in the management of their PIVC and help reduce the risk of device-related complications.

What the quality statement means

For patients

Unless you are unconscious or unable to respond, your clinician will explain why you need to have a PIVC before it is inserted. If your PIVC is inserted in an emergency or while you are unconscious, a carer, relative, or someone who is authorised to make decisions for you, if available, will receive this information.

Your clinician will discuss the risk of complications that might happen if you have a PIVC, how likely they are, and their potential impact. Complications could include blockage, pain, redness, swelling, skin irritation or infection. Information will be presented in a way that you understand so that you can make an informed decision about having a PIVC, and know how you can help prevent complications.

You may need to have a PIVC inserted as part of another procedure you are having. For example, if you are having surgery, a PIVC might be needed to give you the anaesthetic. In these instances, the need for a PIVC will be explained to you as part of your broader treatment plan.

Your clinician will ask questions to make sure you understand the information you have been given. You can ask questions and tell them about problems you have had in the past with PIVCs, or anything that you are concerned about. The information you provide your clinician is important for your comfort, and to reduce the risk of complications.

Your healthcare team will also check with you to make sure your PIVC continues to function properly and is safe for use. You can ask questions and discuss any concerns you have while your PIVC is in place, as well as after it has been removed.

For clinicians

Support the patient to have an active role in preventing PIVC-related complications by providing information and education – for example, by using the principles suggested in the IV-WISE creed on page 18.

Unless it is an emergency, ensure that the need for IV access is discussed with, and understood by, the patient before the PIVC is inserted. This is especially important if several options are available for delivering therapy intravenously or there are specific clinical issues to raise. If a PIVC is required as part of another procedure, provide information about the PIVC when informing the patient about the procedure. If IV access is required in an emergency, ensure that information is provided to a relative or carer, if available.

Ask the patient about previous PIVC insertions to identify any concerns, such as difficulty with particular access sites, allergies to tapes or antiseptics, or certain sites where a PIVC should not be inserted. This will also help to identify whether insertion is likely to be difficult and whether assistance will be required to increase the chances of first-time insertion success.

Invite the patient to ask questions, and use methods such as teach-back to confirm they understand the information they have received. Continue to ask the patient if they have any concerns while the PIVC is in place and for at least 48 hours after it has been removed. This is important because it helps patients have informed discussions with their healthcare team, adhere to their care plan and participate in activities that may help to reduce the risk of PIVC-related complications.

For health service organisations

Ensure that systems are in place for clinicians to provide information and education to patients about their PIVC, to support shared decision making. Also ensure that patients have access to ongoing advice when needed. When consent is being obtained, ensure that policies enable patients to receive enough information to inform their decision about having a PIVC inserted, and support patients to ask questions before the device is inserted and while it is in place. This will help the patient to be engaged in their care and to participate more effectively in decision-making about their treatment. This is consistent with the Partnering with Consumers Standard in the NSQHS Standards (second edition).

For patients

Unless you are unconscious or unable to respond, your clinician will explain why you need to have a PIVC before it is inserted. If your PIVC is inserted in an emergency or while you are unconscious, a carer, relative, or someone who is authorised to make decisions for you, if available, will receive this information.

Your clinician will discuss the risk of complications that might happen if you have a PIVC, how likely they are, and their potential impact. Complications could include blockage, pain, redness, swelling, skin irritation or infection. Information will be presented in a way that you understand so that you can make an informed decision about having a PIVC, and know how you can help prevent complications.

You may need to have a PIVC inserted as part of another procedure you are having. For example, if you are having surgery, a PIVC might be needed to give you the anaesthetic. In these instances, the need for a PIVC will be explained to you as part of your broader treatment plan.

Your clinician will ask questions to make sure you understand the information you have been given. You can ask questions and tell them about problems you have had in the past with PIVCs, or anything that you are concerned about. The information you provide your clinician is important for your comfort, and to reduce the risk of complications.

Your healthcare team will also check with you to make sure your PIVC continues to function properly and is safe for use. You can ask questions and discuss any concerns you have while your PIVC is in place, as well as after it has been removed.

For clinicians

Support the patient to have an active role in preventing PIVC-related complications by providing information and education – for example, by using the principles suggested in the IV-WISE creed on page 18.

Unless it is an emergency, ensure that the need for IV access is discussed with, and understood by, the patient before the PIVC is inserted. This is especially important if several options are available for delivering therapy intravenously or there are specific clinical issues to raise. If a PIVC is required as part of another procedure, provide information about the PIVC when informing the patient about the procedure. If IV access is required in an emergency, ensure that information is provided to a relative or carer, if available.

Ask the patient about previous PIVC insertions to identify any concerns, such as difficulty with particular access sites, allergies to tapes or antiseptics, or certain sites where a PIVC should not be inserted. This will also help to identify whether insertion is likely to be difficult and whether assistance will be required to increase the chances of first-time insertion success.

Invite the patient to ask questions, and use methods such as teach-back to confirm they understand the information they have received. Continue to ask the patient if they have any concerns while the PIVC is in place and for at least 48 hours after it has been removed. This is important because it helps patients have informed discussions with their healthcare team, adhere to their care plan and participate in activities that may help to reduce the risk of PIVC-related complications.

For health service organisations

Ensure that systems are in place for clinicians to provide information and education to patients about their PIVC, to support shared decision making. Also ensure that patients have access to ongoing advice when needed. When consent is being obtained, ensure that policies enable patients to receive enough information to inform their decision about having a PIVC inserted, and support patients to ask questions before the device is inserted and while it is in place. This will help the patient to be engaged in their care and to participate more effectively in decision-making about their treatment. This is consistent with the Partnering with Consumers Standard in the NSQHS Standards (second edition).

Read quality statement 3 - Ensure competency