Hospital saves $400,000 in IV prep time, labor

Product standardization also improves protocol

Shaving off 1.5 minutes in prep time for an IV catheterization may not seem worth counting — until you multiply those minutes by the 167,000 procedures at Baptist Healthcare System, a five-hospital network in San Antonio, TX.

A new prep solution, a combined alcohol-betadyne swab (Becton-Dickinson Vascular Access in Sandy, UT) saves nearly $400,000 a year by reducing average application time as well as the labor to stock per-piece requirements, says Robynn Sweet, RN, infusion consultant. The costs break down to $339,000 in operational efficiency and $54,000 in replacing blood spill linens.

The new swab combines both antiseptics and dries in about 30 seconds. It is part of a kit that contains a drape to protect the bed from blood spill. "Basic-ally it contains everything needed except the IV catheter, so the nurses don’t have to gather each item and restock it separately," Sweet says.

The product also enables nurses to meet best practice protocols as detailed by the Centers for Disease Control and Prevention (CDC) in Atlanta. "The current guidelines call for the area to be prepped first with alcohol then allowed to dry, followed by an application of betadyne dry, which also needs to dry thoroughly," Sweet explains. Using separate products takes from 3.5 to five minutes, depending on drying time.

During Sweet’s needs assessment to establish current practices, she discovered that many nurses were only using alcohol. "We not only wanted to standardize product, but we wanted to maximize indwelling time and reduce chance of infection," she explains.

The average indwelling time is 72 hours. "That’s why you need the betadyne solution so it will emit antimicrobials over the period to reduce bacteria," she explains. "If you just swab with alcohol and then accidentally breathe on the area, the bacteria is back."

Formerly, nurses took about 21 minutes to gather materials and prep the site. With the new product and protocol, it takes 14 minutes and eight seconds, she says.

To determine time and money savings, Sweet first conducted a baseline analysis by interviewing and observing five nurses at the different hospitals. She asked them how many IVs they started in a day and then estimated the number started in a year by multiplying by the number of days worked. She also asked them to show her what items they selected in order to prep a patient and went through inventory to find out which ones were in stock.

Working with the materials manager, infection control nurse, and IV manager, she then asked nurses to test the new product. After the hospital team made the decision to implement, Sweet inserviced nurses on the new product as well as in the CDC protocol.

[Editor’s note: For more information, contact Robynn Sweet, Becton-Dickinson, 9450 S. State St., Sandy, UT 84070. Telephone: (888) 237-2762.]