The insertion and care of peripheral intravenous cannulae (PIVCs) is a role performed by clinical staff that is fundamental to oncology. Previous research indicates nurses' confidence and experience could mediate successful first attempt insertion, increasing the longevity of PIVCs and improving the patient experience.The aim of this audit was to provide a snapshot of care and maintenance of PIVCs, patients' experiences and nurses' confidence at a specialist cancer hospital. An audit tool assessing PIVC care practices (n=51) and a patient experience questionnaire (n=65) were completed. A questionnaire assessing nurses' confidence and training needs was completed by 36 nurses.The findings raise some concerns about clinical practice when inserting PIVCs and ongoing care, with 80% adherence to cannulation policies. Almost half of insertion procedures failed at the first attempt and 17% of nurses lacked confidence in PIVC insertion and in recognising or responding to common complications. Patient satisfaction was high for ongoing PIVC care (95%), although some reported increased pain and anxiety after PIVC insertion, with some unresolved concerns.The audit highlights several important areas for improvement in relation to PIVC insertion and maintenance and the need for greater adherence to clinical guidelines/policy and additional training were identified.

Background - Social influencers of health (SIOH) namely race, ethnicity and structural inequities are known to affect the incidence of out of hospital sudden death (OHSD). We sought to examine the association between SIOH and the incidence of OHSD in the diverse neighborhoods of New York City (NYC) during the first wave of COVID-19 epidemic. Methods - NYC ZIP stratified data on OHSD were obtained from the Fire Department of New York during the first wave of COVID-19 epidemic (March 1 - April 10, 2019) and the same period in 2020. To assess associates of OHSD, ZIP code-specific sociodemographic characteristics for 8,491,238 NYC residents were obtained via the US Census Bureau's 2018 American Community Survey and the New York Police Department's crime statistics. Results - Between March 1 and April 10, 2020, the number of OHSD rose to 4,334 from 1,112 compared to the year prior. Of the univariate ZIP code level variables evaluated, proportions of: Black race, Hispanic/Latino ethnicity, single parent household, unemployed inhabitants, people completing less than high school education, inhabitants with no health insurance, people financially struggling or living in poverty, percent of non-citizens and population density were associated with increased rates of OHSD within ZIP codes. In multivariable analysis, ZIP codes with higher proportions of inhabitants with less than high school education (p < 0.001) and higher proportions of Black race (p = 0.04) were independent predictors for increases in ZIP code rates of OHSD. Conclusions - Educational attainment and the proportion of Black race in NYC ZIP codes remained independent predictors of increased rates of ZIP code level OHSD during the COVID-19 outbreak even after controlling for 2019 rates. To facilitate health equity, future research should focus on characterizing the impacts of structural inequities while exploring strategies to mitigate their effects.

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