Claire M Rickard

Claire M Rickard
The University of Queensland | UQ · School of Nursing Midwifery and Social Work

RN BN GradDipNurs(CritCare) PhD FAAN FAHMS FACN

About

377
Publications
116,662
Reads
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8,057
Citations
Introduction
Providing quality data to make vascular access device complications history. Randomised controlled trials. Systematic reviews. Implementation projects. Focus across device and patient populations.
Additional affiliations
September 2015 - present
The University of Manchester
Position
  • Professor
July 2008 - present
Royal Brisbane and Women's Hospital, Brisbane, Australia
Position
  • Researcher
June 2008 - present
The Prince Charles Hospital (Queensland Health)
Position
  • Researcher

Publications

Publications (377)
Article
Background Peripheral intravenous catheters (PIVCs) are ubiquitous in acute care settings however failure rates are unacceptably high, with around half failing before prescribed treatment is complete. The most effective dressing and securement option to prolong PIVC longevity is unclear. Objectives To determine feasibility of conducting a definiti...
Article
Full-text available
Background Phlebitis is an important complication occurring in patients with peripheral intravascular catheters (PIVCs). The risk factors for phlebitis in the intensive care unit (ICU) was examined. Methods A secondary analysis of a prospective multicenter cohort study was conducted, involving 23 ICUs in Japan—the AMOR–VENUS study. Consecutive pat...
Article
Background/aim: The objective of this study was to describe current surveillance platforms which support routine quality measurement in paediatric critical care. Method: Scoping review. The search strategy consisted of a traditional database and grey literature search as well as expert consultation. Surveillance platforms were eligible for inclu...
Article
The optimal approach for peripheral intravenous catheter (PIVC) insertion in adult hospitalised patients with difficult intravenous access (DIVA) is unknown. The present study aimed to critically appraise the quality of (i) assessment instruments and (ii) clinical practice guidelines (CPGs) or escalation pathways for identifying and managing patien...
Article
Full-text available
Background and significance Intravascular (IV) catheters are the most invasive medical device in healthcare. Localized priority-setting related to IV catheter quality surveillance is a key objective of recent healthcare reform in Australia. We sought to determine the plausibility of using electronic health record (EHR) data for catheter surveillanc...
Article
Full-text available
Objective To understand healthcare worker and patient experience with peripheral intravenous catheter (PIVC) insertion in patients with difficult intravenous access (DIVA) including the use of ultrasound (US). Methods Descriptive study using 1-on-1 semi-structured interviews conducted between August 2020 and January 2021. Purposeful sampling was u...
Article
Background: Needleless connectors (NCs) are essential devices designed to provide safe, needle-free connection between venous access devices, syringes and infusions. There is a variety of designs, and associated decontamination products and practices; the resulting confusion can cause detrimental patient outcomes. This study aimed to explore nurse...
Article
Full-text available
Background Central venous access devices (CVADs) can have high rates of failure due to dressing-related complications. CVADs placed in the internal jugular vein are at particular risk of dressing failure-related complications, including catheter-associated bloodstream infection and medical adhesive-related skin injury. Application of Mastisol liqui...
Article
Aim: To determine peripheral intravenous catheter (PIVC) characteristics, complications and risk factors among patients in cancer units. Methods: A secondary analysis of a global, cross-sectional study (127 hospitals in 24 countries). Participants (≥18 years) admitted to cancer units were assessed once for PIVC characteristics and the presence o...
Article
Objectives: Peripheral intravenous catheters (PIVCs) are frequently used to meet patients' short-term health care needs. However, many PIVCs are not promptly removed at the completion of treatment, placing patients at risk of avoidable harm from serious complications including local and systemic infection. This study aims to report the proportion...
Article
Background Malpositioned central venous access devices (CVADs) can lead to significant patient injury including central vein thrombosis and dysrhythmias. Intra-cavitary electrocardiography (IC ECG) has been recommended by peak professional bodies as an accurate alternative for bedside CVAD insertion, to reduce risk of malposition and allowing immed...
Article
Objectives: To investigate the burden of peripheral intravenous catheters (PIVCs) in older hospitalised patients. Methods: A cross-sectional prospective observational study (2014/2015) to describe the characteristics, indications and outcomes of PIVCs among patients aged ≥65 from 65 Australian hospitals. Results: Amongst 2179 individual PIVCs...
Article
Purpose: This study aimed to gain further knowledge about the comparative effectiveness of chemical disinfectants in reducing the bacterial load of NCs inoculated with S. aureus. Methods: Disinfection of needleless connectors was undertaken in vitro against Staphylococcus aureus comparing 70% isopropyl alcohol (IPA), 70% ethanol, 0.5% and 2% chlorh...
Article
Full-text available
Background Our study aims to explore the experience of having a central venous access device (CVAD) from the perspective of the child and family and how movements within and outside of hospital environments influence this experience. Methods A mixed-methods study was conducted across Children’s Health Queensland (Australia), including inpatient an...
Article
Full-text available
Background: Paediatric peripheral intravenous catheter (PIVC) insertion using traditional landmark insertion technique can be difficult. Aim: To systematically review the evidence comparing landmark to ultrasound guidance for PIVC insertion in general paediatric patients. Study design: Cochrane methodology to systematically search for randomis...
Article
Full-text available
Objectives Rates of unused ( ‘ idle’) peripheral intravenous catheters (PIVCs) are high but can vary per setting. Understanding factors that influence the decision-making of doctors, nurses and paramedics in the emergency setting regarding PIVC insertion, and what factors may modify their decision is essential to identify opportunities to reduce un...
Article
Full-text available
Objective To develop and validate a difficult intravenous access risk assessment and escalation pathway, to increase first time intravenous insertion success in paediatrics. Methods Mixed methods underpinned by literature and co-production principles. Iterative development of the instrument was informed through semi-structured interviews and stake...
Article
Background: Central venous access devices (CVADs) are integral to cancer care provision. Despite the high prevalence of CVAD complications in children with cancer, preventative strategies are understudied. Objective: The aim of this study was to assess study feasibility, occlusive events, thrombolytic use, adverse events, and direct costs of cat...
Article
Aim: To synthesise evidence related to medical adhesive tapes and supplementary securement products for peripheral intravenous catheters in adults, to prevent complications and device failure. Design: Integrative review informed by Whittemore and Knafl and reported in accordance with the PRISMA 2020 statement. Data sources: The Cochrane Centra...
Article
Full-text available
Background Healthcare delivery is reliant on a functional central venous access device (CVAD), but the knowledge surrounding the burden of pediatric CVAD-associated harm is limited. Methods A prospective cohort study at a tertiary-referral pediatric hospital in Australia. Children <18 years undergoing insertion of a CVAD were screened from the ope...
Article
Introduction Peripheral venous catheters (PVCs) are used to administer antimicrobials, but many fail prior to completion of therapy. While some antimicrobials are known to increase PVC failure, risk profiles for many are unclear. Objective To synthesise data from prospective PVC studies conducted between 2013–2019, to determine associations betwee...
Article
Full-text available
Objectives The aim of this study was to examine patient perceptions regarding vascular access quality measurement.MethodsA web-based, cross-sectional survey was performed using a convenience sample of healthcare consumers with vascular access experience, recruited from September 2019 to June 2020. Survey respondents were asked to rate the perceived...
Article
Full-text available
Background Unused ('idle') peripheral intravenous catheters (PIVC) are those not used within 24 hours of insertion. There is little data on cannulation practices and idle PIVC rates in emergency settings, especially the pre-hospital environment. Methods This was an observational cohort study set in south-east Queensland, Australia using data from...
Article
Objective: Insertion and function of pediatric peripheral intravenous catheters (PIVCs) present challenges. We systematically reviewed techniques and technologies to improve PIVC outcomes (first-time insertion success, overall insertion success, time to insertion, dwell time, failure, and complications). Data sources: Cochrane Central Register o...
Article
Purpose The purpose of this scoping review is to conduct a systematic search and establish the current state of evidence for tools and instruments used to measure self-reported outcomes and experiences, including satisfaction scores, specifically for peripheral venous access devices (PVADs). Methods A systematic search of the literature will be co...
Article
Background Vascular access devices suspected of infection are often removed unnecessarily and frequently require replacement. The aim of this study was to identify the prevalence and economic impact of premature, unnecessary device removal due to suspected infection in adult patients admitted to the intensive care unit. Methods Secondary data anal...
Article
Background Peripheral intravenous catheters are an essential medical device which are prone to complications and failure. Objectives Identify patient, provider and device risk factors associated with all-cause peripheral intravenous catheter failure as well as individual complications: phlebitis, infiltration/occlusion, and dislodgement to improve...
Article
Introduction Peripheral intravenous cannulation (PIVC) insertion is challenging for some patients, leading to delays in care and workflow. A few easy-to-identify risk factors can differentiate difficult to cannulate (DIVA) patients. Methods A prospective observational study of adults undergoing PIVC was undertaken. Nursing and medical staff insert...
Article
Full-text available
Background Central venous catheters are prone to infectious complications, affecting morbidity, mortality and healthcare costs. Polyhexamethylene biguanide-impregnated discs at the catheter insertion site may prevent local and bloodstream infection; however, efficacy has not been established in a critical care setting. Objective The objective of t...
Article
Full-text available
Background Bleeding during cardiac surgery is a common complication that often requires the transfusion of blood products. The combination of bleeding and blood product transfusion incrementally increases adverse outcomes including infection and mortality. Following bleeding management guideline recommendations could assist with minimising risk but...
Article
Full-text available
Objective A systematic review on meatal cleaning prior to urinary catheterisation and post catheterisation and reduces the risk catheter-associated urinary tract infections (CAUTIs) and bacteriuria was published in 2017, with further studies undertaken since this time. The objective of this paper is to present an updated systematic review on the ef...
Article
Full-text available
Background The Western Australian Haemodialysis Vascular Access Classification instrument was developed to classify the cannulation complexity of the arteriovenous fistula or arteriovenous graft as simple, challenging, or complex. Although the instrument was developed by experts in haemodialysis nursing, the instrument had not undergone formal vali...
Article
Background Inappropriate needleless connector (NC) care is associated with device failure from catheter occlusion and patient blood stream infections (BSIs). This can be attributed to a lack of knowledge of connector designs and flushing, clamping, and syringe disconnection techniques. This study aimed to assess nurses’ practice, knowledge, attitud...
Article
Objective: To examine the effectiveness of antimicrobial and antithrombogenic materials incorporated into peripherally inserted central catheters (PICCs) to prevent bloodstream infection, thrombosis, and catheter occlusion. Methods: Prospective cohort study involving 52 hospitals participating in the Michigan Hospital Medicine Safety Consortium....
Article
Full-text available
Introduction Peripherally inserted central catheters (PICCs) are vital for the delivery of medical therapies, but up to 30% of PICCs are associated with complications such as deep vein thrombosis or infection. The integration of antimicrobial and hydrophobic catheter materials, and pressure-activated valves, into polyurethane PICCs are innovations...
Article
Background The optimal duration of infusion set use to prevent life-threatening catheter-related bloodstream infection (CRBSI) is unclear. We aimed to compare the effectiveness and costs of 7-day (intervention) versus 4-day (control) infusion set replacement to prevent CRBSI in patients with central venous access devices (tunnelled cuffed, non-tunn...
Article
Full-text available
Purpose: To identify modifiable and non-modifiable risk factors for peripheral intravenous catheter (PIV) failure among patients requiring intravenous treatment for oncology and haematology conditions. Methods: A single-centre prospective cohort study was conducted between October 2017 and February 2019. Adult in-patients requiring a PIV for the...
Article
Background Peripheral intravenous catheters (PIVCs) are medical devices used to administer intravenous therapy but can be complicated by soft tissue or bloodstream infection. Monitoring PIVC safety and quality through clinical auditing supports quality infection prevention however is labour intensive. We sought to determine the optimal patient ‘num...
Article
Background: Peripherally inserted central catheters (PICCs) are commonly placed with the assistance of fluoroscopy or medical imaging, ultrasound, electrocardiogram guidance, or all the above. Innovative ultrasound technologies continue to emerge; however, the impact upon clinical outcomes is not well understood. In this study, we aimed to compare...
Article
Full-text available
en Aims The aim of this systematic review and meta‐analysis was to summarize and quantify peripheral intravenous catheter‐related complications. Design This systematic review is reported by means of the Cochrane process for randomized controlled trials and the Meta‐analysis of Observation Studies in Epidemiology for cohort studies. Data sources...
Preprint
Full-text available
Background Unused ('idle') peripheral intravenous catheters (PIVC) are those not used within 24 hours of insertion. There is little data on cannulation practices and idle PIVC rates in emergency settings, especially the pre-hospital environment. Methods This was an observational cohort study set in south-east Queensland, Australia using data from a...
Article
Introduction Peripheral intravenous catheters (PIVCs) are widely used, but failure is unacceptably common with up to 69% failing before treatment is complete. PIVC securement reduces failure, but the optimal way to achieve this is unclear. Tapes and supplementary securement products are widely used, however rigorous testing of these to reduce PIVC...
Article
Background Transfusion of red blood cell (RBC) concentrates is a common procedure to restore blood volume and tissue oxygen delivery in patients with trauma. Although RBC warmers may prevent hypothermia, some warming or infusion equipment may lead to haemolysis and patient injury. Objectives The aim of this study was to test the effect of (i) RBC...
Article
Full-text available
Background: Peripheral intravenous catheters (PIVCs) are ubiquitous medical devices, crucial to providing essential fluids and drugs. However, post-insertion PIVC failure occurs frequently, likely due to inconsistent maintenance practice such as flushing. The aim of this implementation study was to evaluate the impact a multifaceted intervention c...
Article
Full-text available
Background: Data regarding vascular access device use and outcomes are limited. In part, this gap reflects the absence of guidance on what variables should be collected to assess patient outcomes. We sought to derive international consensus on a vascular access minimum dataset. Methods: A modified Delphi study with three rounds (two electronic s...
Article
Full-text available
Background: To evaluate the feasibility of an efficacy trial comparing a hydrophobic polyurethane peripherally inserted central catheter (PICC) with a standard polyurethane PICC. Methods: This pilot randomised controlled trial (RCT) was conducted between May 2017 and February 2018. Adult participants (n = 111) were assigned to hydrophobic polyur...
Article
Background: Equivalent clinical outcomes, lower costs, and fewer invasive procedures have resulted in revised recommendations for the removal of peripheral intravenous catheters (PIVCs) from the traditional 72- to 96-hourly removal to removal based upon clinical indication. Problem: Uptake of this evidence-based innovation to health systems is o...
Article
Aim Central venous access devices (CVADs) are vital medical devices to support the treatment of paediatric cancer; however, device occlusion is common, which disrupts treatment. This study aimed to improve the identification and management of CVAD occlusions in children with cancer, as well as to identify the demographic, clinical and device charac...
Article
Background Peripherally inserted central catheter tip placement at the cavoatrial junction is associated with reduced catheter-related deep vein thrombosis . Electrocardiographic tip confirmation purportedly improves accuracy of tip placement, but whether this approach can reduce deep vein thrombosis is unknown. Methods Prospectively collected dat...
Article
Background Critically ill patients in an intensive care setting often require arterial catheters for blood pressure monitoring and arterial blood collection. Arterial catheter failure, which manifests in both mechanical and infective forms, remains common. Dressing and securement inadequacies may impact this failure; however, the best method for dr...
Article
Full-text available
Pilot randomized controlled trial (180 patients) of needleless connector decontamination. Central line-associated bloodstream infection occurred in 2% (1/61) of 70% isopropyl alcohol (IPA) wipe, 2% (1/59) of 70% IPA cap, and zero (0/58) infections in 2% chlorhexidine gluconate in 70% IPA wipe patients. Larger definitive trials are feasible and need...
Article
Background: Peripherally inserted central catheters are susceptible to microbial colonisation and subsequent biofilm formation, leading to central line-associated bloodstream infection, a serious peripherally inserted central catheter-related complication. Next-generation peripherally inserted central catheter biomaterials, such as hydrophobic mat...
Article
Full-text available
Objective: To critically review the evidence for the selection and insertion of pediatric vascular access devices (VADs). Data sources: Data were sourced from the US National Library of Medicine, Cumulative Index to Nursing and Allied Health, the Cochrane Library databases, Embase, and international clinical trial databases. Study selection: C...
Article
Full-text available
Objectives: To describe the methodology undertaken to provide guidance on the appropriateness, as well as inappropriateness, of vascular access device selection, characteristics, and insertion technique for pediatric patients. Methods: The RAND Corporation-University of California, Los Angeles Appropriateness Method was used. After definition of...
Article
Full-text available
Objectives: Vascular access device decision-making for pediatric patients remains a complex, highly variable process. To date, evidence-based criteria to inform these choices do not exist. The objective of the Michigan Appropriateness Guide for Intravenous Catheters in pediatrics (miniMAGIC) was to provide guidance on device selection, device char...
Preprint
Full-text available
Background Bleeding during cardiac surgery is a common complication that often requires the transfusion of blood products. The combination of bleeding and blood product transfusion incrementally increases adverse outcomes including infection and mortality. Following bleeding management guideline recommendationscould assist with minimising risk but...
Preprint
Full-text available
Background Bleeding during cardiac surgery is a common complication that often requires the transfusion of blood products. The combination of bleeding and blood product transfusion incrementally increases adverse outcomes including infection and mortality. Following bleeding management guideline recommendations could assist with minimising risk but...