Many facilities have policies requiring clinicians to remove and re-site a Peripheral IV within a given period of time. As a clinician, have you ever wondered if this is actually helps the patient avoid complications?
The CDC’s Guidelines for the Prevention of Intravascular Catheter related Infections indicates that:
1. There is no need to replace peripheral catheters more frequently than every 72-96 hours to reduce risk of infection and phlebitis in adults.
2. No recommendation is made regarding replacement of peripheral catheters in adults only when clinically indicated .
3. Replace peripheral catheters in children only when clinically indicated
Facilities may benefit from reducing the amount or re-sites by reducing work flow for clinicians, and reducing supplies. But is it a good decision for a facility to re-site by indications? Well, in a preliminary study done by Lancet it was found that there was no difference in the percentage of instances of phlebitis in either group when PIVs were re-sited at 70hr intervals or by indication, in adults.
“Interpretation Peripheral intravenous catheters can be removed as clinically indicated; this policy will avoid millions of catheter insertions, associated discomfort, and substantial costs in both equipment and staff workload. Ongoing close monitoring should continue with timely treatment cessation and prompt removal for complications.” – Lancet
– CDC Guidelines for the Prevention of Intravascular Catheter-Related Infections 2011
– Lancet 2012, Routine versus clinically indicated replacement of peripheral intravenous catheters: a randomized controlled equivalence trial