We have been treated with some great conferences this year, globally, with the World Congress on Vascular Access (WOCOVA) in Prague in April. This was followed by the 12th National Infusion and Vascular Access Society (NIVAS) conference last month with the theme of ‘Access in all areas: a new era in vascular access and IV therapy’. Based on the delegates’ collective feedback, the verdicts were ‘extremely informative’,‘knowledgeable speakers’ and ‘extremely well organised’.
More conferences coming up at the latter part of the year include the IVTEAM24 in October and the Infection Prevention Society's IPS IV Forum in December, both in Birmingham, and another IV Therapy Summit on Infiltration and Extravasation in London in October.
There is so much learning derived from conferences, webinars and study days. There are opportunities for networking and collaboration with key opinion leaders and subject matter experts. Alongside these, a plethora of clinical studies, national and international practice guidelines and evidence-based practice guidelines are made available.
Is knowledge power?
With this information overload, one cannot help but wonder: what is being done with all this knowledge? How does this information empower us clinicians?
Most of us believe that knowledge is power, but is it really? Is it not just ‘stored information’, a mere potential to have power? And not until it is used to its specific purpose, in this case clinical practice, can it become empowering.
The importance of hygiene has been known since Semmelweis’ discovery in the 1800s and yet studies still show non-compliance with hand hygiene. Recent years have seen the introduction of safety engineered devices and yet the UK still use non-safety devices.
For this supplement, there are two noteworthy international clinical studies on peripheral IV catheters, both demonstrating knowledge.
Is knowledge applied?
One is from Vascular Access, the Journal of the Canadian Vascular Access Association on the incidences of peripheral intravenous catheter (PIVC)-induced phlebitis and its predictors, with emphasis on care of PIVCs by nurses, among adult inpatients in a public sector tertiary care hospital in Karachi, Pakistan (page S30). It is interesting that the authors have added that an earlier study from Pakistan reported sufficient knowledge regarding PIVC care among nurses, yet the PIVC care practices were not consistent with the standard protocols.
This study found an increased incidence in PIVC-induced phlebitis among adult patients. In addition to patient-related and PIVC-related risk factors considered in this study, PIVC-induced phlebitis was found to be significantly associated with the level of PIVC care provided by nurses. The results show the proportion of PIVC-induced phlebitis among adult hospitalised patients is higher (39.1%) than the 5% rate acceptable by the Infusion Nurses Society. Delay in the initial assessment after PIVC insertion, along with suboptimum PIVC care, significantly increased the risk of developing phlebitis.
Is the recommendation for continuous education, more knowledge or information really the answer?
Putting knowledge into action
The second article, previously published in the Journal of the Association for Vascular Access, from the USA, evaluated the acceptability, usability and ease-of-use of a new safety engineered PIVC with multiple access blood control (page S42). This observational study set out to discover whether this device prevents blood exposure at insertions and subsequent hub access and the number of attempts experienced clinicians undertook to get a ‘successful stick’. The outcome showed 93.6% acceptability and clinicians did not have to change their insertion technique, found the catheter easy to insert, and believed the catheter would protect them from blood exposure during insertion of the catheter and subsequent hub accesses.
This is knowledge in action, yielding improvements in a care pathway, thereby increasing patient satisfaction and ultimately enhancing patient safety. We need to make actionable steps, applying what has been learnt in practice. Knowledge is not power. It is inert. If it is not used appropriately in practice application, it is merely stored information.