Austin ED, Sullivan SB, Whittier S, Lowy FD, Uhlemann AC. Peripheral intravenous catheter placement is an underrecognized source of Staphylococcus aureus bloodstream infection. Open Forum Infect Dis. 2016; 3:(2)

Berenholtz SM, Pronovost PJ, Lipsett PA Eliminating catheter-related bloodstream infections in the intensive care unit. Crit Care Med. 2004; 32:(10)2014-2020

Eggimann P, Harbarth S, Constantin MN, Touveneau S, Chevrolet JC, Pittet D. Impact of a prevention strategy targeted at vascular-access care on incidence of infections acquired in intensive care. Lancet. 2000; 355:(9218)1864-1868

Health Protection Surveillance Centre. Point prevalence survey of hospital acquired infections & antimicrobial use in european acute care hospitals, May 2017: national report Ireland—December 2018. 2018. (accessed 24 March 2020)

Jackson A. Reflecting on the nursing contribution to vascular access. Br J Nurs. 2003; 12:(11)657-665

Jarvis WR. The United States approach to strategies in the battle against healthcare-associated infections, 2006: transitioning from benchmarking to zero tolerance and clinician accountability. J Hosp Infect. 2007; 65:3-9

Limoges J, Acorn S. Transforming practice into clinical scholarship. J Adv Nurs. 2016; 72:(4)747-753

Loveday HP, Wilson JA, Pratt RJ epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. J Hosp Infect. 2014; 86:S1-S70

Mermel LA. Short-term peripheral venous catheter-related bloodstream infections: a systematic review. Clin Infect Dis. 2017; 65:(10)1757-1762

O'Grady NP, Alexander M, Burns LA Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis. 2011; 52:(9)e162-93

Orsolini-Hain L. Educating nurses: a call for radical transformation. Nurs Educ Perspect. 2010; 31:(5)327-328

Ray-Barruel G, Xu H, Marsh N, Cooke M, Rickard CM. Effectiveness of insertion and maintenance bundles in preventing peripheral intravenous catheter-related complications and bloodstream infection in hospital patients: a systematic review. Infect Dis Health. 2019; 24:(3)152-168

Resar R, Pronovost P, Haraden C, Simmonds T, Rainey T, Nolan T. Using a bundle approach to improve ventilator care processes and reduce ventilator-associated pneumonia. J Comm J Qual Patient Saf. 2005; 31:(5)243-248

Rickard CM, McCann D, Munnings J, McGrail MR. Routine resite of peripheral intravenous devices every 3 days did not reduce complications compared with clinically indicated resite: a randomised controlled trial. BMC Med. 2010; 8:(1)53-53

Ullman AJ, Cooke ML, Gillies D Optimal timing for intravascular administration set replacement. Cochrane Database Syst Rev. 2013; (9)

Wall D. Evaluation: improving practice, influencing policy. In: Swanwick T (ed). : Wiley Online Library; 2010

Webster J, Osborne S, Rickard C, Hall J. Clinically-indicated replacement versus routine replacement of peripheral venous catheters. Cochrane Database Syst Rev. 2010; (3)

Webster J, Osborne S, Rickard CM, New K. Clinically-indicated replacement versus routine replacement of peripheral venous catheters. Cochrane Database Syst Rev. 2015; (8)

World Health Organization). WHO guidelines on hand hygiene in health care. First global patient safety challenge: clean care is safer care. 2009. (accessed 24 March 2020)

Clinically indicated replacement of peripheral vascular catheters: is it safe for patients?

23 April 2020
Volume 29 · Issue 8


Replacing peripheral vascular catheters when clinically indicated rather than routinely has multiple benefits for patients and practitioners. Managing vascular catheters based on clinical indication provides early opportunities for intervention, or catheter removal or replacement. Where clinically indicated, peripheral vascular catheters can be used for a long time, and this is aided by decision-making tools such as the visual infusion phlebitis score and care bundles. Fewer cannulations result in less pain, better patient comfort and a lower risk of infection. For each cannulation avoided, about 20 minutes can be saved for other care activities. Replacing peripheral vascular catheters according to clinical indication can improve patient safety and optimise resource use.

Peripheral vascular cannulation is one of the most common invasive clinical procedures undertaken in modern healthcare. Common indications for peripheral catheters include intravascular access being required to administer medications, fluid and electrolyte therapy, as well as for aiding diagnostic procedures. The use of intravascular catheters is associated with risk of local and systemic infections. Catheter-associated bloodstream infection (BSI) is a significant risk.

Strategies to minimise the risk of catheter-associated BSI include replacing peripheral vascular cannulas (PVCs) at regular intervals; however, international guidelines vary on the frequency of replacement. The US Centers for Disease Control guidelines recommend replacing peripheral intravenous (IV) catheters no more frequently than every 72–96 hours (O'Grady et al, 2011). A Cochrane review update (Webster et al, 2015) found no evidence to support changing catheters at 72–96 hours, reaffirming the original Cochrane recommendation in 2010 (Webster et al, 2010).

Register now to continue reading

Thank you for visiting British Journal of Nursing and reading some of our peer-reviewed resources for nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • Unlimited access to the latest news, blogs and video content