Improving Documentation of Intravenous Cannulation in a Resource-Limited Teaching Hospital: A Two-Cycle Quality Improvement Audit.

backgroundIncomplete documentation of intravenous (IV) cannulation is a common problem that compromises patient safety, accountability, and continuity of care. This study aimed to evaluate the impact of introducing a standardized IV cannula documentation sticker on compliance with documentation standards in a resource-limited hospital.

methodsA two-cycle quality improvement (QI) audit was conducted at Al-Managil Teaching Hospital, Sudan, in 2025. In Cycle 1 (March 20-April 2), 50 inpatient records were retrospectively reviewed for compliance with IV cannula documentation standards. A one-month intervention was then implemented, introducing a standardized documentation sticker supported by staff training, posters, and ward-level reminders. Cycle 2 (June-September) reviewed another 50 records prospectively. Data were analyzed using frequencies, percentages, and chi-square tests, with p < 0.05 considered statistically significant.

resultsDocumentation compliance improved markedly across all parameters following the intervention. In Cycle 1, compliance ranged from 0 to 68%, while in Cycle 2, most parameters reached ≥ 95%. For example, documentation of insertion site improved from 4% to 100%, aseptic technique from 2% to 96%, and complications from 4% to 96%. Flushes/patency checks, while significantly improved (0% to 80%), remained lower than other domains. All improvements were statistically significant (p < 0.001).

conclusionsIn a resource-limited setting, a structured documentation sticker, combined with staff education, achieved near-universal compliance with IV cannula documentation standards. This low-cost, scalable intervention has the potential to strengthen patient safety, accountability, and quality of care. Sustaining progress will require re-auditing, ongoing staff reinforcement, and targeted focus on maintenance documentation.