Solving the problem of IV dislodgement
Most patients in hospital will have some form of intravenous (IV) catheter in situ at some time to facilitate the administration of IV therapy. Accidental dislodgement, although widespread, is often unrecognised as a contributor to IV catheter failure. Dislodgement usually contributes to the delay in the administration of treatment, time-consuming IV restarts and a potential need for more invasive procedures. Dislodgement has serious implications, with costs to both patient and healthcare costs. Historically, prevention of IV catheter dislodgement has focused on the use of the correct securement methods and technique; however, these fail in many occasions, for example, where patients are confused or during bed transfers. In the recent years, new breakaway connector systems, such as ReLink, have been designed, which allow the tubing to become disconnected when undue pressure or pull is placed on it. This is done by a safety release valve that breaks apart, sealing off both ends of the tubing in an aseptic manner, while shutting off medication flow and preserving IV catheter integrity. Awareness raising and education focusing on accidental IV catheter dislodgement and the different ways to reduce its incidence in clinical practice would improve patient safety and potentially have significant healthcare savings.
Many patients admitted to hospital or receiving care in any other setting, including at home, will receive intravenous (IV) therapy at some point (NHS Scotland, 2002; Royal College of Nursing (RCN), 2016; National Institute for Health and Care Excellence, 2017).
These patients will require a peripheral intravenous catheter or cannula (PIVC) or a central venous access device (CVAD) to be inserted to facilitate the delivery of IV treatment. Zhang et al (2016) determined that in the UK, one in three inpatients will have at least one PIVC in situ at some time while in hospital.
Although safe and easy to insert, PIVCs are associated with a number of risks and high failure rates that are costly to patients, practitioners and healthcare systems.
Shaw (2017) and Helm et al (2015), analysed data from the USA and estimated that on average more than 300 million PIVCs are used per year. Moreover, Steere et al (2019) revealed that an average of 10 PIVCs were used per patient admission, which implies there is a very high failure of PIVC insertion and related care and maintenance, and excess cost associated with such interventions.
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