Improving use of peripheral intravenous catheters – what’s the new ‘standard’ of clinical care?

Ms Debbie Carter1, Mr Herbert Down1, Associate Professor Amanda Walker1

1Australian Commission On Safety And Quality In Health Care, Sydney, Australia

Background:

About 70% of hospitalised patients require a peripheral intravenous catheter (PIVC) during their hospitalisation, making their insertion one of the most common procedures performed. Despite this, about 50% of PIVCs are not used. Complications are common, resulting in 90% of PIVCs being removed before therapy completion. Australian and international data suggest there is variation in the care provided to patients to optimise PIVC use. The Australian Commission on Safety and Quality in Health Care (ACSQHC) sought to develop a clinical care standard to improve care to patients with PIVCs.

Method:

In 2019, the ACSQHC convened a roundtable to discuss issues relating to PIVC insertion, management and removal.  A working group was then formed, representing infectious diseases, infection control, paediatrics, anaesthetics, and consumers with experience in PIVC use. The group reviewed evidence on the use of PIVCs, including guidelines, systematic reviews and grey literature.  Feedback from public consultation was considered and the standard was endorsed by key professional societies.

Results:

Ten quality statements were developed describing the pathway of care to optimise PIVC use: identifying need, patient education, clinician competency, first insertion success, device and site selection, securement, routine use, removal and replacement.  Consumer and clinician fact sheets were also developed, and indicators to support clinicians monitor how well they implement the care.

Conclusion:

The ACSQHC is supporting health services to reduce complications associated with PIVCs through promoting judicious use, highlighting the importance of maintaining and preserving vessel health, developing indicators, and linking to national safety and quality standards.


Biography:

Debbie leads the development of clinical care standards at the Australian Commission on Safety and Quality in Health Care. Prior to this, she was a Team Leader at NPS MedicineWise. Debbie has over 12 years’ of clinical pharmacy experience in public and private hospital settings. She has experience in all therapeutic areas, as well as specialised knowledge in haematology, bone marrow transplantation, and palliative care.

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