Comparison of Routine Replacement With Clinically Indicated Replacement of Peripheral Intravenous Catheters

Abstract

IMPORTANCE Peripheral intravenous catheters (PVCs) are the most frequently used indwelling devices in hospitals worldwide. Peripheral intravenous catheter bloodstream infections (PVC-BSIs) are rare, but severe and preventable, adverse events. OBJECTIVE To investigate the incidence of PVC-BSIs after changing the policy of routine PVC replacement every 96 hours to clinically indicated replacement. DESIGN, SETTING, AND PARTICIPANTSThis institution-wide, observational cohort study evaluated all patients hospitalized at a large university-affiliated hospital with 10 sites in

Lower risk of peripheral venous catheter-related bloodstream infection by hand insertion

“…The insertion site was inspected daily. PVCs were routinely replaced every 96 h, except for the period from April 2018 to October 2019, during which PVCs were replaced when clinically indicated only [ 7 ].…”

Update on prevention of intra-vascular accesses complications

“…It may allow a prompt initiation of therapy with vasopressors and avoid the insertion of a CVL [6]. Routine (96 h) vs as needed PIVC replacement to prevent catheter-related bloodstream infection (CRBSI) remains a controversial issue for ICU patients [7,8].…”

Keeping Patients Safer: Reviewing Predictors of Success and Failure of Short Peripheral Intravenous Catheters

“…[1][2][3] Although repeated Cochrane reviews demonstrated no increase in infection with adoption of clinical indication, 4,5 several studies have revealed conflicting results. [6][7][8] More recently, a large prospective study in Switzerland revealed a substantial increase in infection after adopting clinical indication practices, which resolved once returning to routine rotation practices. However, implementation did not include any enhancements to baseline short PIVC insertion and care practices.…”

“…Since 2011, the Infusion Therapy Standards of Practice (previously titled Infusion Nursing Standards of Practice ) have supported goals of clinical indication rather than time-based site rotation of short peripheral intravenous catheters (short PIVCs). In 2016, as well as 2021, the guidance has been to remove short PIVCs “when clinically indicated, based on the findings from site assessment and/or clinical signs and symptoms of systemic complications.”1–3 Although repeated Cochrane reviews demonstrated no increase in infection with adoption of clinical indication,4,5 several studies have revealed conflicting results 6–8. More recently, a large prospective study in Switzerland revealed a substantial increase in infection after adopting clinical indication practices, which resolved once returning to routine rotation practices.…”

“…More recently, a large prospective study in Switzerland revealed a substantial increase in infection after adopting clinical indication practices, which resolved once returning to routine rotation practices. However, implementation did not include any enhancements to baseline short PIVC insertion and care practices 7…”