Management of Peripheral Intravenous Catheters Clinical Care Standard

If a patient requires medicines or fluids, assess the patient to identify the most appropriate route of administration for their clinical needs before starting therapy. Consider whether another route of administration (for example, the oral, intramuscular, subcutaneous, rectal, intra-osseous or intra-peritoneal route) is appropriate, before using the IV route.

If all other routes of administration have been excluded and IV access is needed, assess whether peripheral or central venous access is appropriate by considering the:

• patient’s medical history, age, clinical and vascular condition
• expected duration of therapy
• likelihood of repeated or prolonged administration of vesicants or irritants such as vancomycin, flucloxacillin, potassium or certain types of chemotherapy
• patient’s history of infusion therapy and whether there were complications associated with its use – for example, difficulty locating suitable veins
• availability of appropriate insertion sites and the likelihood of first-time insertion success
• position of the patient during any planned procedures
• patient’s lifestyle, body image, and preferences for therapy and location of the device, and whether therapy can be delivered safely in accordance with their preferences
• availability of resources and ability to care for the device.

Insertion of a PIVC pre-emptively may be appropriate for patients at risk of clinical deterioration. Collection of pathology samples is not a valid reason to insert a PIVC; although this often happens in emergency departments, it can lead to unused PIVCs being left in. If frequent sampling is required, exceptions may be considered after individual assessment; examples include, fourth hourly troponin levels, to optimise patient comfort, or if there is difficult venous access. PIVCs should not be used to obtain blood cultures as this leads to an increased risk of contamination to the blood culture and PIVC.

By discussion with the patient, ascertain that they understand the need for IV therapy, especially if multiple device options are available, specific clinical issues about the therapy need to be raised, or the patient has concerns.

Ensure that organisational policies and processes support the consideration of all routes of administration of medications and fluids before therapy is started, and that the IV route is only used if other routes are not suitable.

If you need to have medicines or fluids, your clinician will assess what is the best way for you to have them. It might be as a tablet or liquid that you can swallow, or as an injection into your muscle or under your skin.

Sometimes the best way might be directly into your bloodstream. If this is the case, your clinician will talk with you about whether a PIVC is right for you. In some cases, a different way of delivering treatment into your bloodstream might be needed. This may depend on:

• how long you need to have treatment
• the condition of your veins and the chances of being able to successfully insert a PIVC
• the treatment you need to have and whether it could damage your veins, especially if given for a long time
• your history of having PIVCs inserted and whether there were any problems, such as finding your veins
• where the PIVC should be inserted, taking into account your preferences and whether therapy can be delivered safely
• whether you already have a device in place for receiving medicines and fluids intravenously.

Support the patient to have an active role in preventing PIVC-related complications by providing information and education – for example, by using the principles suggested in the IV-WISE creed on page 18.

Unless it is an emergency, ensure that the need for IV access is discussed with, and understood by, the patient before the PIVC is inserted. This is especially important if several options are available for delivering therapy intravenously or there are specific clinical issues to raise. If a PIVC is required as part of another procedure, provide information about the PIVC when informing the patient about the procedure. If IV access is required in an emergency, ensure that information is provided to a relative or carer, if available.

Ask the patient about previous PIVC insertions to identify any concerns, such as difficulty with particular access sites, allergies to tapes or antiseptics, or certain sites where a PIVC should not be inserted. This will also help to identify whether insertion is likely to be difficult and whether assistance will be required to increase the chances of first-time insertion success.

Invite the patient to ask questions, and use methods such as teach-back to confirm they understand the information they have received. Continue to ask the patient if they have any concerns while the PIVC is in place and for at least 48 hours after it has been removed. This is important because it helps patients have informed discussions with their healthcare team, adhere to their care plan and participate in activities that may help to reduce the risk of PIVC-related complications.

Ensure that systems are in place for clinicians to provide information and education to patients about their PIVC, to support shared decision making. Also ensure that patients have access to ongoing advice when needed. When consent is being obtained, ensure that policies enable patients to receive enough information to inform their decision about having a PIVC inserted, and support patients to ask questions before the device is inserted and while it is in place. This will help the patient to be engaged in their care and to participate more effectively in decision-making about their treatment. This is consistent with the Partnering with Consumers Standard in the NSQHS Standards (second edition).

Unless you are unconscious or unable to respond, your clinician will explain why you need to have a PIVC before it is inserted. If your PIVC is inserted in an emergency or while you are unconscious, a carer, relative, or someone who is authorised to make decisions for you, if available, will receive this information.

Your clinician will discuss the risk of complications that might happen if you have a PIVC, how likely they are, and their potential impact. Complications could include blockage, pain, redness, swelling, skin irritation or infection. Information will be presented in a way that you understand so that you can make an informed decision about having a PIVC, and know how you can help prevent complications.

You may need to have a PIVC inserted as part of another procedure you are having. For example, if you are having surgery, a PIVC might be needed to give you the anaesthetic. In these instances, the need for a PIVC will be explained to you as part of your broader treatment plan.

Your clinician will ask questions to make sure you understand the information you have been given. You can ask questions and tell them about problems you have had in the past with PIVCs, or anything that you are concerned about. The information you provide your clinician is important for your comfort, and to reduce the risk of complications.

Your healthcare team will also check with you to make sure your PIVC continues to function properly and is safe for use. You can ask questions and discuss any concerns you have while your PIVC is in place, as well as after it has been removed.

Ensure that you complete training and education as specified by your health service organisation that is relevant to your scope of practice, and that you are assessed as competent in using and adhering to the current, evidence-based practices to preserve vessel health and prevent complications associated with using a PIVC. If you are working towards achieving competency, when you insert a PIVC ensure you are supervised by someone who has successfully completed a competency assessment of their practical skills and knowledge in this area.

Maintain continuing education to ensure that your practical skills and knowledge remain in line with current practice recommendations, and that your competency is maintained and documented according to your health service organisation’s policies.

Use evidence-based guidelines to identify the practical skills and knowledge required to successfully insert and manage PIVCs. Based on these guidelines, develop policies outlining the competency and assessment required for clinicians, relevant to their scope of practice, and how competency will be monitored.

Validate competency using systems such as checklists or forms that focus on measurable assessment of performance, and use a standardised approach to assess competency so that infusion therapy practices are consistent across the organisation. Have a system for assessing competency of clinicians who have come from other facilities.

Ensure that competency is documented according to local policy. Monitor and review competency for feedback to clinicians and ongoing quality improvement.

Develop workforce competency as appropriate to the size of the organisation, as well as the availability of a competent work force after hours. Options include subspecialty or vascular access champions for greater first-time insertion success.

If you need to have a PIVC inserted, you have a right to expect that the member of your healthcare team who performs the procedure has relevant training and assessment of their skills in this area. In some instances, clinicians who are in training may insert your PIVC under supervision. You can also expect that the clinicians inserting and looking after your PIVC will keep their skills and knowledge up to date.

Identify a suitable insertion site by taking into account the potential risk of infection, mechanical complications and patient comfort, preferably using veins in the non-dominant arm. Ask the patient if they have a preference for the location of the PIVC, and follow their preference if this would allow safe administration of therapy. When choosing an appropriate site, consider for each patient:

• the condition of the patient’s skin and vasculature at the insertion site
• any contraindication to choosing which limb, for example, axillary lymph node clearance, or presence of arteriovenous fistula
• how painful insertion might be for the patient
• whether your expertise matches the complexity of the insertion procedure at the site so that the device can be inserted successfully on the first attempt; ultrasound may assist you to identify more appropriate sites.

Use a site that is likely to last the duration of the prescribed therapy to maximise dwell time and patient comfort. This means choosing a site that will promote self-care, prevent accidental removal or blockage, and facilitate the safe administration of therapy. Avoid areas of flexion unless clinically necessary; re-site cubital fossa IVs as soon as appropriate. Do not use veins in the lower extremities unless this is necessary; for example, because of a risk of tissue damage and local site complications in the upper extremities.

Choose the right peripheral device (length and gauge) by considering the type of therapy the patient needs, including whether the PIVC is to be used to administer contrast media for diagnostic purposes, and the duration of treatment. Use devices with safety-engineered protective features to reduce the risk of injury involving a sharp.

Ensure that policies describe the criteria for selection of PIVC insertion sites and types of devices.

Ensure that clinicians involved in choosing insertion sites are adequately trained, and know how to select the most appropriate PIVC and insertion site for the patient’s intended therapy. This includes knowing the:

• patient’s clinical condition
• insertion technique for the specific device
• potential for complications
• appropriateness of the device for the prescribed therapy.

Ensure devices with safety-engineered protective features are available at the point of care to reduce the risk of injury involving a sharp. Examples include devices such as needles with guards, sliding sheaths, shields, blunted tips or retracting needles.

Your clinician will assess you to see where your PIVC should be placed, considering:

• your preferences for its location and whether therapy can be delivered safely there
• the condition of your veins and skin
• how much you can move
• whether it will be painful
• how likely it is that they will be able to insert it on the first attempt.

If possible, your PIVC will be placed in the arm that you use the least and locations where problems are more likely to develop will be avoided.

If the clinical presentation of a patient is such that the likelihood of inserting a PIVC successfully on the first attempt is low given your current experience in PIVC insertion, follow your health service organisation’s policy for guidance on how to maximise first-time insertion success. Strategies to optimise first-time insertion success include escalating to a more experienced clinician, using technology-assisted devices such as ultrasound, or adjunct supportive therapies such as local anaesthetics. For paediatric patients, consider using parental support or child play therapy to maximise the likelihood of successful insertion on the first attempt.

Difficult or unsuccessful insertions can cause bruising, thrombosis, delays in treatment, reduced access to veins for future health needs, and undue pain and anxiety for the patient. This is why it is important to conduct a thorough assessment of risk factors that may contribute to difficult insertion, ask the patient about whether they have had issues 

Support clinicians and promote a culture of maximising first-time insertion success by having policies describing how to achieve this goal. Policies and processes should include:

• what to do if insertion is likely to be difficult
• recommendations to escalate before any attempt to insert a PIVC if the complexity of the insertion is outside the clinician’s expertise
• specified conditions under which more than one attempt may be appropriate (such as lack of more experienced staff in the after-hours setting).

Strategies to support first-time insertion success may involve referring to a more experienced clinician to ensure that the expertise to insert the PIVC matches the complexity of the patient’s clinical presentation, or use of technology-assisted devices such as ultrasound, especially after hours when staffing may be limited. Adequate staff training in the use of technology-assisted devices is required to ensure that they maximise first-time insertion success.

Your health service organisation will have a process that describes what your healthcare team should do to avoid too many attempts at inserting your PIVC. For example, if your clinician cannot locate your veins, the process outlines what steps they should follow. They might need to refer you to another clinician or use an ultrasound to help, or use other supportive therapies such as local anaesthetics to help keep you comfortable while your PIVC is inserted.

If they try to insert your PIVC and cannot, it can cause your treatment to be delayed. This is why it is important for your clinician to conduct a thorough assessment of the risk factors that might make inserting your PIVC difficult, and for you to say if you have had any issues with PIVCs in the past.

Insert and secure a PIVC using standard precautions, including aseptic technique.

Carry out a risk assessment to identify the standard precautions required to safely perform the procedure, including performing hand hygiene consistent with the ‘5 Moments for Hand Hygiene’, and adhering to aseptic technique.

If there is hair at the insertion site, remove with clippers as shaving with a razor increases the risk of infection. Decontaminate the skin with 2% chlorhexidine gluconate in 70% alcohol unless contraindicated, allowing for appropriate cleaning and drying time.

Use a sterile, transparent, semipermeable dressing to secure the PIVC, and consider patient characteristics such as allergies to tapes. Secure the dressing, taking care not to contaminate the insertion site. Ensure that the dressing remains intact for the duration of the insertion to prevent complications such as unintended dislodgement.

Ensure that PIVCs are labelled in accordance with the National Standard for User-applied Labelling of Injectable Medicines, Fluids and Lines (the Labelling Standard). Specifically, catheters must be identified when there is a risk of wrong route of administration (for example, where the patient entry port is distant from the administration site).

Ensure that policies and procedures are in place that describe the requirements for the safe insertion and securement of PIVCs. Ensure that policies and procedures outline:

• who can insert a PIVC
• what is needed to insert and secure a PIVC, including skin preparation, equipment and dressings
• what infection control measures to use
• how to dispose of the equipment used to insert and secure the PIVC.

Ensure that systems are in place to enable clinicians to complete training in standard precautions, including the '5 Moments for Hand Hygiene' and aseptic technique. Ensure compliance with the Labelling Standard.

Standard precautions are steps your clinician will use to help reduce your risk of infection when they are providing care for you, including when they insert your PIVC. This will include thoroughly cleaning their hands immediately before they touch you and your PIVC, using gloves, and other techniques to prevent germs from getting onto your PIVC and into your bloodstream.

If there is any hair at the insertion site, your clinician will remove it with clippers. They will not shave the hair with a razor as this increases the risk of infection. An antiseptic liquid will be used to clean your skin before your PIVC is inserted, and a dressing will be applied after insertion to help the PIVC stay in place and prevent infection. This is why it is important to tell your clinician about any allergies you have, including allergies to any tapes, so the antiseptics and dressings that are used are best for you.

Ensure that the plan of care for a patient’s PIVC is recorded according to local policy in a place that is easily accessible to all clinicians involved in the patient’s care.

Support clinicians to maintain accurate and complete healthcare records about a patient’s infusion therapy by ensuring that organisational policies and procedures describe the complete requirements for documentation, where to document and how often documentation should occur.

At a minimum, documentation should include information about inserting, maintaining and removing PIVCs, and reviewing the insertion site.

If an electronic system is used for records, ensure that it captures the date and time of insertion, and confirms that the PIVC has been removed before the patient is discharged from hospital. Details about any adverse events such as infection, infiltration or extravasation, and the actions taken to deal with them, should also be documented.

Ensure that complete and accurate healthcare records are available at the point of care so that all clinicians involved in the patient’s care are aware of the plan for the patient’s infusion therapy. Monitor documentation procedures to ensure that they adhere to the organisational process, and provide feedback to clinicians as part of ongoing quality improvement.

Information about your PIVC will be discussed with you and recorded in your healthcare record or chart. This may include why the PIVC is needed, the type of PIVC, when it was inserted and by whom, its location, the therapy you are receiving, when the PIVC is expected to be removed and when it is actually removed. Your PIVC will be checked regularly and the findings will be noted down. If complications develop, the complications and what your clinician did about them will also be recorded. This will help your healthcare team to be aware of decisions made about your PIVC and any problems that arise.

Routinely inspect the PIVC and insertion site, for signs of complications that can lead to device failure. This should happen at least once per shift (or per eight hours) and when accessing the device, or if the patient raises any concerns about it. More frequent inspection may be required for some patients, or according to local policy, for example for paediatric patients. In particular, check:

• for signs of pain, swelling or redness at the insertion site, by visual inspection through the transparent dressing and gentle palpation through the dressing
• the condition of the patient’s veins, and whether they have become hardened or thrombosed
• for signs of localised or systemic infection; if either are confirmed, report as per local policy in an incident management system
• for leakage of fluid from the insertion site, signs of occlusion, infiltration or extravasation
• whether the PIVC remains appropriately dressed and secured.

As part of the review, ask the patient questions to check whether they are tolerating their PIVC, and whether they understand why it is needed and the treatment they are having. Explain the reasons for checking the device, and the signs and symptoms you are looking for that might suggest that problems are developing.

Ask the patient if they have any concerns associated with the use of their PIVC and deal with these concerns. Check that the patient knows what signs and symptoms to report, including local site complications such as pain, redness, swelling, skin irritation or fever. Advise about the importance of telling their clinician if they think complications are developing so that they can be addressed immediately.

Use standard precautions, including aseptic technique, when accessing the PIVC or performing site care to help reduce the risk of PIVC-associated infections. Decontaminate needleless connectors before and after access with 70% alcohol or other solution recommended in current evidence-based or best-practice guidelines, and allow to fully air dry.

Flush the PIVC using a solution recommended in current evidence-based or best-practice guidelines and at intervals according to local policy, to maintain line patency, reduce the risk of blockage, and prevent mixing of incompatible medicines or fluids.

Ensure that evidence-based policies and procedures are in place outlining what is needed to access, maintain and flush a PIVC. Ensure that equipment is available at the point of care to ensure that hand hygiene and aseptic technique are maintained every time the PIVC is reviewed, accessed or flushed.

To make sure your PIVC continues to function properly, your clinician will check your PIVC at least once every shift or every eight hours, each time they use the device, and if you raise any concerns about it.

Specifically, your clinician will check:

• for pain, swelling or redness of your skin around your PIVC
• for any signs of infection, including fever (feeling hot, cold or shivery)
• for leaking or blockage
• that your PIVC is still firmly in place
• that the dressing covering the insertion site has not become bloodstained, wet or loose
• whether anything else about your PIVC is concerning you.

Your clinician will provide regular care to prevent complication from developing, but it is important that you tell your clinician if you notice any of these problems.

Each time your PIVC needs to be touched, your clinician will thoroughly clean their hands and take precautions to make sure the PIVC stays clean. They will check that your PIVC is flowing properly (patency), and will also flush it from time to time to make sure it does not get blocked.

It is important that you do not touch, fiddle with or move your PIVC.

Review and document the ongoing clinical need for a patient’s PIVC at least once per day, or more often if clinically indicated. Review whether switching from IV to oral therapy is possible. Remove the PIVC immediately if it is no longer required.

If extended IV therapy is anticipated, consider whether an alternative device, such as a peripherally inserted central catheter or central line, should be inserted (see Quality statement 1).

Ensure that policies are in place which describe the need for at least daily review of ongoing need for IV access, and for immediate removal of PIVCs when they are no longer needed.

Your clinician will review your PIVC at least once a day to make sure that it is still needed. If it is not needed any more, it will be removed. If your PIVC has not been used in the last 24 hours, ask your clinician if it is still needed.

Remove PIVCs as soon as they are no longer needed – for example, if a patient can tolerate oral therapy – or if complications occur. Signs and symptoms that indicate that the PIVC should be removed include:

• pain and tenderness at the insertion site, with or without palpation
• warmth, redness or swelling
• leakage of fluid from the insertion site
• resistance when flushing or absence of blood return.

Ensure removal and replacement of PIVCs is in accordance with the current version of the Australian Guidelines for the Prevention and Control of Infection in Healthcare (see Box 6).

Document the reason for removal of the PIVC and the condition of the site. Observe the insertion site for 48 hours after the PIVC is removed for signs of post-infusion pain, redness or swelling. If the patient is discharged from hospital, explain what signs they should look out for after the PIVC is removed and who they should contact if signs of infection develop.

Replace with a new PIVC if ongoing vascular access is required. If extended IV therapy is anticipated, consider whether an alternative device, such as a peripherally inserted central catheter or central line, should be inserted (see Quality statement 1).

Consider re-siting PIVCs, within 24 hours, when adherence to aseptic technique is uncertain or unknown, such as insertion during a medical emergency.

For hospitalised patients, ensure that PIVCs are removed before discharge, unless the PIVC is intended to continue beyond discharge as part of the patient’s care plan.

Ensure that systems are in place that state the considerations for when a PIVC should be removed and replaced, and monitor adherence to guideline recommendations for ongoing quality improvement. These systems should be based on a formal risk assessment that takes into account:

• the availability of staff appropriately trained in the insertion, monitoring, assessment and maintenance of PIVCs on each shift
• the quality of PIVC surveillance in the healthcare facility, including surveillance of regular inspection of the site and device, and of PIVC-related Staphylococcus aureus bacteraemia (SAB)

The need for robust documentation and reporting processes on device insertion, maintenance and removal that is supported by the results of audits.

Your PIVC will be removed when it is no longer needed. If you are unsure when it will be removed, ask your clinician.

If your PIVC has malfunctioned or there are signs of problems such as pain, redness or swelling, and your treatment is not finished yet, your clinician will need to remove your PIVC and replace it with a new one. Your clinician will also make sure that your PIVC is replaced as often as current Australian guidelines recommend.

If you are going home and your PIVC is still in place, ask your clinician if it can be removed.

• Ensure systems and processes support people to self-report their Aboriginal and Torres Strait Islander status and to record self-identification.
• Ensure all staff engage regularly in cultural safety training.
• Implement the six actions for Aboriginal and Torres Strait Islander Health from the NSQHS Standards.

• Provide flexible service delivery to optimise attendance and help develop trust with individual Aboriginal and Torres Strait Islander people and communities.
• Establish robust communication channels and referral pathways with primary healthcare providers (including Aboriginal Community Controlled Health Organisations [ACCHOs]).
• Where possible, provide outreach services close to home, on Country or in collaboration with ACCHOs or other community healthcare providers.

• Take a collaborative approach to ensure that interventions are suitably tailored to the individual’s personal needs and preferences for care.
• Encourage the inclusion of support people, family and kin or the person’s trusted healthcare provider (such as their ACCHO) in all aspects of care, including decision making and planning treatment and management.
• Engage culturally appropriate interpreter services and cultural translators when this will assist the patient.
• Involve Aboriginal and Torres Strait Islander Health Workers or Aboriginal and Torres Strait Islander Health Practitioners as part of a patient’s multidisciplinary team and involve Aboriginal and Torres Strait Islander Liaison Officers in hospital settings.
• Use culturally and linguistically appropriate materials to aid in communication and discussion, accounting for varying levels of health literacy.

The insertion of a PIVC is one of the most common clinical procedures performed, with up to 70% of hospitalised patients requiring a PIVC at some point during their hospital stay. However, studies estimate that 4% to 28% of PIVCs inserted are never used. This is even higher in Australian emergency departments, where about 50% of PIVCs inserted are not used, placing patients unnecessarily at risk of infection.

Despite their frequency of use, PIVCs are reportedly associated with complications almost 70% of the time, including:

• blockage and dislodgement
• redness and swelling of the vein
• infection.

Unfortunately, not all attempts to insert PIVCs are successful. Nearly half of all first insertion attempts fail, causing undue pain and anxiety for patients as a result of multiple failed attempts.

To reduce rates of complications associated with PIVC use, best practice guidelines recommend a range of strategies. Despite this, data from Australia and internationally suggest that a significant proportion of patients do not receive care as recommended to optimise use of PIVCs.

Read more about the scope and goal of this Standard or see further background in the Management of Peripheral Intravenous Catheters Clinical Care Standard. 

The Standard applies to all healthcare settings where PIVCs may be inserted or managed, such as:

• all hospital settings, including public and private hospitals, subacute facilities, and outpatient and day procedure services
• emergency services, such as ambulance services
• general practice and other community settings where peripheral intravenous catheters may be used, including outreach services such as Hospital in the Home settings.

Not all quality statements in this Standard will be applicable to every healthcare service or clinical unit. Healthcare services should consider their individual circumstances in determining how to apply each statement. 

When implementing this Standard, healthcare services should consider:

• the context in which care is provided
• local variation
• quality improvement priorities of the individual healthcare service. 

In rural and remote settings, different strategies may be needed to implement the standard. For example, the use of:

• hub‑and‑spoke models integrating larger and smaller health services and ACCHOs
• telehealth consultations
• multidisciplinary teams including allied health involvement where clinically appropriate.

This Standard relates to the care that patients of all ages, in all healthcare settings should receive to reduce complications associated with the insertion, maintenance and removal of PIVCs. 

Although many of the quality statements are relevant for vascular access in general, this Standard has been developed specifically in relation to the use of PIVCs.

National Safety and Quality Health Service Standards

Monitoring the implementation of Clinical Care Standards helps healthcare services to meet some of the requirements of the:

• National Safety and Quality Health Service Standards (NSQHS Standards) for acute services
• National Safety and Quality Primary and Community Healthcare Standards (Primary and Community Healthcare Standards) for services that deliver health care in a primary and/or community setting. 

Find out more about how healthcare services are expected to implement the national standards in How to use the Clinical Care Standards.

The Commission is committed to supporting healthcare services to provide culturally safe and equitable healthcare to all Australians. 

Person-centred care recognises and respects differences in individual needs, beliefs, and culture. The Commission: 

• is committed to supporting healthcare services to provide culturally safe and equitable healthcare to all Australians
• acknowledges that discrimination and inequity are significant barriers to achieving high‑quality health outcomes for some patients from culturally and linguistically diverse communities.

Culturally safe service provision and environments are those where the places, people, policies and practices foster mutual respect, shared decision making, and an understanding of cultural, linguistic and spiritual perspectives and differences. Cultural safety is supported by organisations and individuals that recognise cultural power imbalances and actively address them by: 

• ensuring access to and use of interpreter services or cultural translators when this will assist the patient and aligns with their wishes
• providing visual or written information in a language that the patient, their family and carers will understand
• providing cultural competency training for all staff
• encouraging clinicians to review their own beliefs and attitudes when treating and communicating with patients
• identifying variation in healthcare provision or outcomes for specific patient populations, including those based on ethnicity, and responding accordingly.

The Management of Peripheral Intravenous Catheters Clinical Care Standard has been endorsed by 19 key organisations:

• Alliance for Vascular Access Teaching and Research
• Australasian College for Emergency Medicine
• Australasian College for Infection Prevention and Control
• Australasian Society for Infectious Diseases
• Australian and New Zealand College of Anaesthetists
• Australian and New Zealand Society for Geriatric Medicine
• Australian and New Zealand Society for Vascular Surgery
• Australian College of Paramedicine
• Australian College of Rural and Remote Medicine
• Australian Healthcare and Hospitals Association
• Australian Vascular Access Society
• Cancer Nurses Society of Australia
• College of Emergency Nursing Australasia Ltd
• The Australian College of Phlebology
• The Council of Ambulance Authorities
• Day Hospitals Australia
• Royal Australasian College of Physicians
• Royal Australian and New Zealand College of Radiologists
• Royal College of Pathologists of Australasia

The Standard was developed following consultation with a roundtable meeting of healthcare managers, infection control clinicians and consumers, with further advice from a small topic working group drawn from the roundtable meeting. Feedback was also obtained during public consultation and incorporated into the final version. 

The Peripheral Venous Access Working Group was established to provide clinical advice, expertise and consumer input during the development of the Standard. The group included individuals with relevant expertise and experience in the Australian health care system and representatives of some key organisations. 

Peripheral Venous Access Clinical Care Standard - Working Group

The role of the Working Group was to:

• advise on the scope and key components of care for the Standard
• advise on key sources of evidence including clinical practice guidelines, standards and empirical literature to build upon the body evidence supporting the existing model
• advise on the formulation of quality statements and supporting indicators
• recommend strategies to support the implementation of the Standard
• actively support raising awareness of the Standard.

The role of consumer members is to advise the Commission on matters relating to their experience, as a patient or carer, and provide this perspective for the development of the Standard.

All members are required to disclose financial, personal and professional interests that could, or could be perceived to, influence a decision made, or advice given to the Commission. Disclosures are updated prior to each meeting and managed in line with the Commission’s Policy on Disclosure of Interests.

The quality statements in the Standard are based on the best available evidence and guideline recommendations at the time of development. 

Further information is available on the evidence sources underpinning the Standard.

Evidence sources - Management of Peripheral Intravenous Catheters Clinical Care Standard

To inform development of the Standard, the Commission engaged the Queensland University of Technology (QUT) and KP Health to carry out two literature reviews:

• Infections associated with peripheral venous access devices: A rapid review of the literature
• Peripheral intravenous catheters: A review of guidelines and research