Development of an Extended Dwell Peripheral Catheter Program

South Western Sydney Local Health District


The team aimed to develop an extended dwell peripheral catheter program to reduce multiple, painful cannulation attempts and complication rates related to peripheral catheters in patients with difficult venous access.

An insertion algorithm was developed to provide the most suitable intravascular device based on ultrasound assessment.

Results showed:
  • 4 in every 5 catheters were inserted at first attempt
  • The insertion algorithm contributed to the majority of devices remaining in place until the cessation of therapy
  • Phlebitis rates were minimal and no infections were reported. 
The program has been successful with many devices in dwell for weeks with no complications (totalling 1645 catheter days). Complication rates were significantly lower than has previously been described.

Domestic Violence Routine Screening in Paediatrics

Sydney Local Health District

Domestic Violence Routine Screening (DVRS) in Paediatrics
The team aimed to routinely screen eligible mothers/female carers for domestic violence (DV) at the Children’s Ward at Royal Prince Alfred Hospital.

Utilising improvement science, drivers for practice improvement were identified. The program has three essential elements:
  • Education – ongoing education
  • Screening - routine screening on the Children's Ward
  • Response Pathway - social work intervention and/or legal response through the Health Justice Partnership. 
​In the first 46 weeks, 557 screens were completed. There were 22 disclosures of DV - a rate of 4%. All were offered support and free legal advice through the Health Justice Partnership. This has been a valuable program that improves patient safety and facilitates access to specialist support.

Right Care, Right Time, Right Outcome

Mid North Coast Local Health District


Documented and anecdotal evidence demonstrates a divide between drug and alcohol treatment rationale, good clinical practice and patient experiences. The team aimed to improve emergency treatment access for consumers requiring alcohol withdrawal management. 

Drug & Alcohol Services developed a Triage Category Rating Guide based on NSW Clinical Guidelines. A first in Australia, the Guide assists emergency departments in detecting actual or risk of alcohol withdrawal and identifying most appropriate treatment and referral pathways.

Results showed an increase in:
  • appropriate treatment from 31.8% to 80.0%
  • alcohol use documentation from 35.4% to 55.2%. 
​The Guide was trialed in Kempsey Emergency Department and collaborative research results have been accepted in Emergency Medicine Australasia Journal.
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Current as at: Friday 7 September 2018
Contact page owner: Strategic Communications and Engagement