G94(P) Improving cannulation efficiency in the children’s hospital

Aim To introduce standardised cannulation trolleys across the Children’s Hospital to decrease time spent gathering equipment. Method A questionnaire was sent to junior doctors enquiring about cannulation practices across the wards in the Children’s Hospital. Junior doctors were then timed gathering the necessary cannulation equipment on all of the paediatric wards. A pilot standardised cannulation trolley was trialled on the children’s assessment unit, and junior doctors were timed gathering equipment with the new trolleys. Adjustments were made to the equipment layout after feedback from staff, including photographs of equipment inserted into the trolley drawers to facilitate appropriate re-stocking. Standardised cannulation trolleys were disseminated across all wards in the Children’s Hospital. A cannulation trolley champion was nominated for each ward. Random stock checks have been performed. Results In the baseline survey 88% of doctors agreed that ‘it often takes me longer to find the equipment I need for cannulation than inserting the cannula’. 1–6 cannulas were inserted per junior doctor per shift. The time taken to gather cannulation equipment at baseline was 4.21 minutes on average, the maximum time was 10 minutes. After the trial of the cannulation trolley on the assessment unit it took 2.12 minutes. This is an initial reduction of 50%. A second spot audit of the cannulation trolleys has been undertaken. All wards had well stocked cannulation trolleys and it now takes 58 seconds to gather everything needed for cannulation. If we scale this up and have on average 20 doctors working during the daytime, and each doctor sites 1–6 cannulas per shift, 84.2–505.2 minutes were spent gathering cannulation equipment compared to 19.3 minutes to 116 minutes currently. Conclusion In an era of less staff and the need to improve efficiency, this simple implementation has hugely decreased the time spent preparing to cannulate, a common junior doctor job. This has enabled quicker cannulation especially in time critical circumstances such as sepsis.