References
Standards of care for peripheral intravenous catheters: evidence-based expert consensus
Abstract
Background:
The insertion of a PIVC is the most commonly performed invasive procedure in healthcare. Despite its frequency in placement in hospitalized patients, PIVCs are generally perceived as being safe; however, the prevalence of failure ranges from 35%-50%. Additionally, complications are common and often deemed ‘acceptable’ by clinicians. Healthcare provider and clinician foundational knowledge and competency is lacking nationally. Considering the mere volume of PIVCs placed, the failure and complication rates, the human impact is significant.
Methods:
The Association for Vascular Access (AVA) has led a collaborative effort with representatives from the Infusion Nurses Society (INS), the American Association of Critical Care Nurses (AACN), ECRI, and content experts representing nursing vascular access, infusion therapy, infection prevention, critical care, pediatrics, healthcare leadership, a physician, and a patient representative. Our aim is to provide concise guidance that will enhance and standardize practices related to PIVC. By consolidating current standards of practice into a comprehensive document, our framework seeks to advance the quality of care and improve patient safety.
Results:
This document has undergone meticulous scrutiny to ensure its quality, including incorporation of current standards, methodology for consensus from the expert panel, and input received from public comments.
Conclusions:
We anticipate that this work will have a significant impact on healthcare professionals, policymakers, and, most importantly, patients’ experiences by the promotion of consistent, high-quality treatment, safety, and comfort for patients receiving a PIVC.
In the landscape of modern healthcare, peripheral intravenous catheter (PIVC) insertion is a cornerstone procedure, critical for the administration of therapies, medications, and fluids to a wide array of patients in a variety of settings. Annually, the US alone purchases an estimated 350 million PIVCs, making it the most frequently performed invasive procedure in healthcare.1 Its prevalence is underscored by Helm et al, who highlighted that 60%-90% of hospitalized patients in the US require a PIVC during their care and experience PIVC failure rates ranging from 35%-50%.2 This high failure rate has been persistent, as shown by Cooke et al, who reported even higher global rates of 33%-69% PIVC failures before treatment completion.3
Despite its commonality, PIVC practice variability leads to a range of complications such as infiltration, infection, and patient discomfort. Reports such as that by Zingg et al, corroborate a troubling global prevalence of PIVC failure, marked at 35% to 50%.4 The Australian Commission on Safety and Quality in Health Care further amplifies this concern with indications of complication rates up to 70%.5,6 The consistency in these findings is echoed in a systematic review by Marsh et al, which noted that at least one-third of PIVCs inserted globally fail before the completion of the intended therapy.7 Such complications are not just statistical concerns; they represent a grave risk to patient welfare and highlight the urgency for improved insertion and care practices.
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