Photo Credit: MihailDechev
Overall, clinicians utilize guidance for inserting peripheral IV catheters, and studies show clinical and financial benefits associated with such guidelines.
“Peripheral intravenous catheters (PIVCs) are the most commonly used invasive devices in acute care hospitals, with nurses being primarily responsible for the insertion and care of these devices,” researchers noted in the Journal of Infusion Nursing.
Rama Thyagarajan, MD, MPH, and colleagues conducted a point prevalence study that examined current PIVC status and nursing documentation in a large, regional healthcare system and variables associated with PIVC complications.
The study included adult patients and a total of 665 PIVCs.
Overall Compliance With Recommendations High
The analysis found that dressings were clean, dry, and intact in 83% of observations; only 2.7% did not have a transparent dressing. More than a quarter (31%) of PIVCs were inserted in areas of flexion.
The median dwell time was 2.39 days (±2.36 days), with upper arm sites having the longest dwell time.
Overall inter-rater reliability for an infiltration or phlebitis score of 0 was high (97.4% and 92%, respectively). However, overall agreement was only 77.16% for infiltration and 40.07% for phlebitis, with considerable differences as scores increased.
Dr. Thyagarajan and colleagues wrote that the findings show strong compliance with the vascular access practice recommendations from the Infusion Nurses Society’s Infusion Therapy Standards of Practice. However, they noted that opportunities exist to improve infiltration and phlebitis assessment and documentation.
Benefits of Vascular Access Education & Training
Findings from another study published in PLOS ONE show that “strategic investment in vascular access education and training can yield impressive financial returns while simultaneously enhancing vascular access outcomes.”
Researchers in this study examined the impact of a formal, standardized training program called Operation STICK (OSTICK) in peripheral venous access. The analysis included 21,259 PIVCs: 1,681 OSTICK and 19,578 non-OSTICK PIVCs.
The estimated incremental cost-effectiveness ratio for the OSTICK group versus the non-OSTICK group was −$221.964 per 10 percentage points of PIVC dwell time to hospital length of stay increase. In addition to being more cost-effective, the OSTICK group saw increases in the proportion of catheter dwell time relative to hospital length of stay (P<0.001) compared with those in the non-OSTICK group.
“It is imperative for organizations to recognize the significant impact of such initiatives and prioritize the implementation of comprehensive programs,” study investigators wrote.
