dgkh000223 10.3205/dgkh000223 urn:nbn:de:0183-dgkh0002235 Letter to the Editor Egerton-Warburton Egerton-Warburton Diana D

Emergency Department, Monash Medical Centre, Monash Health, Melbourne, Victoria, Australia Department of Medicine, Southern Clinical School, Monash University, Melbourne, Victoria, Australia

author Craig Craig Simon S Dr.

Emergency Department, Monash Medical Centre, 246 Clayton Rd, Clayton, Victoria, Australia, 3168Emergency Department, Monash Medical Centre, Monash Health, Melbourne, Victoria, AustraliaDepartment of Medicine, Southern Clinical School, Monash University, Melbourne, Victoria, Australia

Simon.craig@monashhealth.org author Stuart Stuart Rhonda R

Department of Medicine, Southern Clinical School, Monash University, Melbourne, Victoria, Australia Monash Infectious Diseases, Monash Health, Melbourne, Victoria, Australia

author Dendle Dendle Claire C

Department of Medicine, Southern Clinical School, Monash University, Melbourne, Victoria, Australia Monash Infectious Diseases, Monash Health, Melbourne, Victoria, Australia

author German Medical Science GMS Publishing House

Düsseldorf

610 compliance peripheral venous catheter insertion standard operating procedure 20140307 engl 2196-5226 9 1 GMS Hygiene and Infection Control GMS Hyg Infect Control 03 LetterReply to: Improving patient safety during insertion of peripheral venous catheters: an observational intervention study. GMS Hyg Infect Control. 2013; 8(2):Doc18 We would like to congratulate Kampf and colleagues on their study, which demonstrates the effectiveness of a multimodal intervention to improve safety for the insertion of peripheral intravenous catheters (PIVC) . The issue of nosocomial infection is a small but real risk associated with the insertion of PIVC . While we support and agree with the approach of the authors, we feel they may have missed an important initial step – ensuring that the PIVC is needed in the first place. We performed a study in our institution that demonstrated that 50% of PIVC inserted in adult patients in our emergency department were unused . Of those subsequently admitted to hospital, a similar proportion still had an unused PIVC at 72 hours. While some of these unused PIVC may have still been appropriate, it is likely to be a small minority. We described this situation as “pain without gain”. The safest, least painful and least costly peripheral venous catheter is one that was never inserted in the first place. We would encourage vigilance by health professionals for all aspects of PIVC. This should include monitoring of usage rates and ensuring that they are only inserted if there is a reasonable likelihood of being used. NotesCompeting interestsThe authors declare that they have no competing interests.ReplyPlease read the reply to this letter: . Kampf G Reise G James C Gittelbauer K Gosch J Alpers B Improving patient safety during insertion of peripheral venous catheters: an observational intervention study 2013 GMS Hyg Infect Control Doc18 Kampf G, Reise G, James C, Gittelbauer K, Gosch J, Alpers B. Improving patient safety during insertion of peripheral venous catheters: an observational intervention study. GMS Hyg Infect Control. 2013;8(2):Doc18. DOI: 10.3205/dgkh000218 http://dx.doi.org/10.3205/dgkh000218 Stuart RL Cameron DR Scott C Kotsanas D Grayson ML Korman TM Gillespie EE Johnson PD Peripheral intravenous catheter-associated Staphylococcus aureus bacteraemia: more than 5 years of prospective data from two tertiary health services 2013 Med J Aust 551-3 Stuart RL, Cameron DR, Scott C, Kotsanas D, Grayson ML, Korman TM, Gillespie EE, Johnson PD. Peripheral intravenous catheter-associated Staphylococcus aureus bacteraemia: more than 5 years of prospective data from two tertiary health services. Med J Aust. 2013 Jun;198(10):551-3. DOI: 10.5694/mja12.11699 http://dx.doi.org/10.5694/mja12.11699 Limm EI Fang X Dendle C Stuart RL Egerton Warburton D Half of all peripheral intravenous lines in an Australian tertiary emergency department are unused: pain with no gain? 2013 Ann Emerg Med 521-5 Limm EI, Fang X, Dendle C, Stuart RL, Egerton Warburton D. Half of all peripheral intravenous lines in an Australian tertiary emergency department are unused: pain with no gain? Ann Emerg Med. 2013 Nov;62(5):521-5. DOI: 10.1016/j.annemergmed.2013.02.022 http://dx.doi.org/10.1016/j.annemergmed.2013.02.022 Kampf G Reise G James C Gittelbauer K Gosch J Alpers B We agree: the less insertions, the better 2014 GMS Hyg Infect Control Doc02 Kampf G, Reise G, James C, Gittelbauer K, Gosch J, Alpers B. We agree: the less insertions, the better. GMS Hyg Infect Control. 2014;9(1):Doc02. DOI: 10.3205/dgkh000222 http://dx.doi.org/10.3205/dgkh000222 0 0 0 0