Needle-free non-injectable arterial connector (NIC)
The Innovation and Technology Tariff (ITT) was introduced to incentivise the adoption and spread of transformational innovation in the NHS.
It aims to remove the need for multiple local price negotiations and guarantees automatic reimbursement when an approved innovation is used.
The Problem
Potential problems with arterial lines that could lead to patient harm were highlighted in the 2008 National Patient Safety Agency Rapid Response Report.
This included confusion of arterial and venous lines leading to medication errors.
Errors with sampling such as excess blood spillage.
Bacterial contamination of the arterial line. Incidents related to arterial line medication errors are rare but consequences are often very severe, causing serious damage to the arterial blood vessels and surrounding tissue in the hand, and it can lead to amputation.
Gangrenous
Gangrenous necrosis of the hand following an accidental intra-arterial injection of promethazine, Keene et al. Accidental Intra-Arterial Injection.
J Oral Maxillofac Surg 2006
The Solution
Needle-free non-injectable arterial connector (NIC) is a standard arterial connector with a safety valve built into the device.
The NIC is connected to the sampling port of an arterial line and through which blood gas samples can be collected.
NIC would replace arterial connectors currently used in adults with arterial lines (it is not currently licensed for use in children).
Promotes patient safety by eliminating inadvertent injection into the arterial line and by reducing potential for infection.
NIC is part of the National Innovation Accelerator and will attract the NHS England Innovation and Technology Tariff from April 2017.
Savings associated with eliminating medication errors
Near miss – £57/incident – cost of time taken to report and document incident.
Incident with no lasting harm – £2230/incident – cost of additional time needed in critical care, medications, surgery, radiology, staff time.
Incident with lasting harm – > £4000 per incident (> £10,000 with amputation) – cost of additional time needed in critical care, medications, surgery, radiology, staff time.
How to order?
Provider organisations will order the NIC direct from the supplier (AmDel Medical). Supplier will invoice NHS England for the devices, who will pay for the devices. No cost outlay to the provider organisations.
Arterial Fixation Device
The dressing has higher adhesion to the skin, due to its large contact area reducing the chance of the line being accidentally removed.
In accordance with existing colour coding systems for arterial equipment it also clearly marked as an arterial line in red to indicate the potential risks.
There is a large Window in the centre of the dressing so that the insertion site can be monitored.