Professor Claire Rickard1,2,3, Ms Emily Larsen1,2, Ms Nicole Marsh1,2, Professor Joan Webster1,2, Mr Gabor Mihala1,2, Dr Naomi Runnegar3
1Griffith University, Nathan, Australia
2Royal Brisbane and Women’s Hospital, Herston, Australia
3Princess Alexandra Hospital, Woolloongabba, Australia
Introduction: Bloodstream infections (BSI) can develop from Peripheral Intravenous Catheters (PIVCs) however the relationship of BSI to dwell time is not well understood.
Methods: We synthesized data from multiple prospective research studies in Australia (12 studies; 12,942 PIVCs) with rigorous prospective collection of dwell times and infection outcomes using National Health and Safety Network 2018 criteria. PIVCs were inserted in a range of clinical departments and by various inserters; and IV insertion teams were rare. Post-insertion care was by bedside nursing staff using routine hospital policies. Infections were blind-adjudicated. Dwell times were calculated from insertion and removal times, and life tables constructed.
Results: PIVC Line Associated BSI (PLABSI) occurred in 6/12,942 (0.05%) PIVCs or 0.14/1000 PIVC days; of these cases, 3/12,942 (0.02%; 0.07 per 1000 PIVC days) met the criteria for PIVC Related BSI (PRBSI). In addition, there were 3/12, 942 (0.02%) local infections. PIVCs were in place for <1 to 42 days and primary BSIs occurred on dwell days 2 to 7, with no significant difference in risk by day of dwell (p>0.05).
Conclusion: While infections can occur, and ongoing vigilance is required to prevent them, this prospective, rigorous follow up of PIVCs identified a low rate of associated BSI and local infections under typical Australian hospital conditions. There was no significant increase in BSI risk with dwell time. We caution that all PIVCs should be monitored daily and removed as soon as no longer needed, if there is any complication or suspicion of infection.
Emily Larsen has been a Senior Research Assistant with the Alliance for Vascular Access Teaching and Research (AVATAR) since 2013. In that time, she has managed single and multi-centre clinical studies (primarily randomised controlled trials). She is currently project managing the National Health and Medical Research Council funded ‘PISCES Trial’, exploring dressing and securement methods for Peripherally Inserted Central Catheters (PICCs) inserted within a Cancer Care Services cohort.