Invasive medical devices

Note: This action is only applicable if your healthcare service uses invasive medical devices in the provision of health care.

Invasive medical devices are devices inserted through skin, mucosal barrier or internal cavity. Examples of these include intravenous devices, dental implants, catheters, curettes, podiatry forceps or acupuncture needles.

Use of invasive medical devices during the provision of health care increases the risk of infection and provides a route for infectious agents to enter the body. Aseptic insertion and careful maintenance of devices is critical to reducing infection risk.

The current edition of the Australian Guidelines for the Prevention and Control of Infection in Healthcare recommends processes for invasive medical devices. These include:

• Criteria for the insertion, and selection of the best device for patient indications and purpose
• Indications for the device to be left in place once inserted
• Assessment of aseptic technique used at insertion and for maintenance activities
• Use of evidence-based safety-engineered technology
• Evaluation of how clinicians choose the most appropriate device
• Physical environment issues that affect insertion and maintenance of devices
• Patient monitoring activities to identify infections relating to invasive medical devices
• Patient engagement and education about the use and maintenance of invasive medical devices
• Indication for removal, evidence-based removal procedure and post-removal assessment of possible complications (for example, air emboli, bleeding from removal site).

• What procedures are delivered in your healthcare service that require the use of invasive medical devices?
• How does your healthcare service identify risks associated with the different invasive devices?
• What processes does your healthcare service use to ensure appropriate use and management of invasive medical devices, consistent with the current edition of the Australian Guidelines for the Prevention and Control of Infection in Healthcare?
• How is your workforce supported to use and manage invasive medical devices appropriately?

• Identify procedures where invasive medical devices are used in the provision of health care. 
• Develop processes to support the workforce appropriately use and manage invasive medical devices.
• Review incident reports relating to invasive medical devices for appropriateness, infection, referral, inconsistency or noncompliance with organisational policy, equipment failure and other adverse events.
• Provide the workforce with training for the appropriate use and management of invasive medical devices.

The type and comprehensiveness of evidence used is dependent on each healthcare service context, but could include:

• List of the invasive medical devices in use in the healthcare service and where they are used
• Documents outlining the process for appropriate use and management of invasive medical devices, including the selection, insertion, maintenance and removal of invasive medical devices 
• Examples of records in which use of invasive medical devices was discussed
• Observation of use of invasive medical devices as per the healthcare service’s processes 
• Actions taken to manage identified risks with the selection, insertion, maintenance and removal of invasive medical devices
• Records of workforce training and competency in the insertion/maintenance and removal of invasive devices.

Commission resources

• Addendum NSQHS Standards Accreditation Workbook 2021 Infection Prevention and Control Standard – provides users with updated information on reflective questions and examples of evidence for the 2021 Preventing and Controlling Infections Standard within the NSQHS Standards. Principles and strategies are broadly applicable.
• Management of Peripheral Intravenous Catheters Clinical Care Standard – describes best-practice care for using peripheral intravenous catheters (PIVCs) – also known as ‘cannulas’. 
• Infection and Prevention Control eLearning Module – a course covering the basics of infection prevention and control.
• Infection and Prevention Control eLearning Module – a course covering the principles of infection prevention and control.

Other resources

• National Health and Medical Research Council in collaboration with the Commission: Australian Guidelines for the Prevention and Control of Infection in Healthcare (2019): Section 3.5.2 Invasive Medical Devices – developed to specifically support improved infection prevention and control in acute health settings and provides a risk management framework to ensure that the basic principles of infection prevention and control can be applied to a wide range of healthcare settings.