Improving patient safety using clinical needs assessments in IV therapy.

A clinical needs assessment (CNA) consulting programme was initiated with the NHS Healthcare Purchasing Consortium to improve safety and reduce risk in intravenous (IV) therapy through standardization, best practice guideline adherence and ensuring adequate training. The results of CNAs conducted at two acute NHS Trusts (A and B) are summarized. Fifteen-minute 'pump needs assessment' and 'clinical practice review' interviews were conducted with junior and senior staff members, and recommendations were made to a multidisciplinary Trust-steering committee. Post-assessment recommendations included: standardizing to one pump type with activated medication error reduction software, purchasing optimal numbers of IV pumps, implementing best practice guidelines and protocols to minimize unnecessary IV set tear-down (removing and replacing IV set), the use of standardized accessories and ensuring adequate training. Both assessments showed that streamlining, best practice adherence and training could result in pronounced cost savings and improve patient safety. Importantly, the cost savings could facilitate implementation of CNA recommendations. The Trusts have since prioritized standardizing IV pumps and accessories and future implementation of medication error software. The CNA is a valuable tool for Trusts that positively impacts on patient safety.