Peripheral intravenous catheters: A review of guidelines and research
Prof Samantha Keogh and Dr Saira Mathew from the Queensland University of Technology have prepared this report on behalf of the Australian Commission on Safety and Quality in Health Care.
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Support was also provided by the following authors in preparing this report:
Dr Evan Alexandrou, A/Prof Andrew C. Bulmer, Prof Marie Cooke, Dr Linda Coventry, Alexandra Hawthorn, Tricia Kleidon, Emily Larsen, Nicole Marsh, Anthony Marshall, Dr Gillian Ray-Barruel, Stephen Sinclair, Eugene Slaughter, Alana St John, Kerry Taliaferro, A/Prof Amanda Ullman, and Prof Claire M. Rickard from the Australian Vascular Access Society (AVAS).
The insertion of a peripheral intravenous catheter (PIVC) is one of the most common clinical procedures performed. About 30 million are used in Australia each year, 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 not actually needed, placing the patient unnecessarily at risk of infection.
Despite frequency in PIVC use, complications are reported to be as high as 70%. They can be prone to blockage and dislodgment, cause inflammation of the vein and infection. Nearly half of all first insertion attempts also fail, causing undue pain and anxiety for patients as a result of multiple failed attempts.
To reduce rates of PIVC-related complications, a number of evidence-based strategies have been suggested. Best practice guidelines recommend a range of strategies to reduce risk of complications and increase chances of PIVC success. 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.
A clinical care standard on peripheral intravenous access will aim to support national consistency of best practice for the insertion and management of PIVCs. To inform development of this clinical care standard two literature reviews were undertaken.
The Commission engaged Professor Samantha Keogh and Dr Saira Mathew from the Queensland University of Technology (QUT) to conduct a literature review to better understand the current clinical environment of the techniques used for preventing and managing adverse events associated with the insertion and use of PIVCs.