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HBOK 1-096

Title Enhancing Intravenous Services: A CQI Approach
Author(s) Cynthia A. Goodrich, Kimberly S. Woodley, Ellen M. Morrison, and Eleanor H. Garrett
Source Quality Progress
Topic Performance Measurement

Performance Improvement

Abstract A continuous quality improvement (CQI) program and the focus-analyze-develop-execute (FADE) process helped the staff at Virginia Baptist Hospital in Lynchburg, VA, re-engineer its intravenous (IV) services.  These services had undergone a paradigm change, as IV management shifted from hospital IV teams to the nursing staff.  When patient surveys indicated that satisfaction with IV services delivered by nurses was low, an interdisciplinary CQI team went into action.  Through brainstorming and analysis of patient and nurse surveys, it determined that many nurses were uncomfortable with the IV process.  The team developed an assessment tool to measure patient risk for difficult IV access.  This screening tool examined five factors, including: age, diagnosis, history of difficult access, skin integrity, and upper extremity condition.  The team also created a resource pyramid linked to assessment tool risk scores.  For example, a patient with a mid-range risk score became a candidate for assistance from experienced IV troubleshooters, while a low risk patient could have the IV started by an admitting nurse.  This re-engineering effort has helped raise patient satisfaction scores.
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Reference Code 1-096

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