Management of Peripheral Intravenous Catheters Clinical Care Standard

CPD Hours: 1.5
Current as at 19 October 2021
Peripheral intravenous catheter (PIVC) insertion for the administration of medications and intravenous (IV) fluids is the most common invasive procedure performed in acute care facilities worldwide. PIVCs are inserted in approximately 70% of hospitalized patients.

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“Examine the requirements of the standard for the management of PIVC”

Course Content

Peripheral intravenous catheter (PIVC) insertion for the administration of medications and intravenous (IV) fluids is the most common invasive procedure performed in acute care facilities worldwide. PIVCs are inserted in approximately 70% of hospitalized patients.

One possible complication of catheterization is phlebitis, or inflammation of the vein, which may be chemical (caused by the infused substance), mechanical (caused by the device itself) or infective (due to microbial colonization of the catheter or IV site). Repeated instances of phlebitis can lead to difficulties with venous access and possibly result in the need for central venous access. PIVC failure as a result of phlebitis may lead to increased health care costs associated with equipment, staff time, prolonged hospital stay and bloodstream infection. Therefore, the timely detection of complications and removal of the cannula is essential.

Post-infusion phlebitis may occur up to 48 h after PIVC removal, necessitating continued assessment of the site. In addition to phlebitis, irritation of the vein may be accompanied by a variety of conditions including infiltration, extravasation, vein occlusion or PIVC blockage, and it can be challenging to differentiate between these conditions and phlebitis as they can produce similar signs and symptoms.

Other PIVC-related complications, such as accidental removal, occlusion, thrombosis, and PIVC-related infection, are also problematic. Likewise, difficult intravenous access leads to repeated insertion attempts that might prove to be uncomfortable for the patients, and expensive for the health institutions. The practitioners must develop the awareness of the factors capable of increasing the difficulty of defining the appropriate vein for cannulation through their varied experiences with vein location and vascular access.

These standards benefit patients and health services alike, with the potential for large cost savings. The standards promote that peripheral intravenous cannula insertion can be reduced using a multimodal approach designed to support critical thinking and promote clinically appropriate peripheral intravenous cannula insertion and use. Specific considerations include the emphasis on the patient-centred, evidence-based nature of the intervention, policy change to meet existing local needs, provision of quality, accessible education and resources, and regular audit and feedback to clinical staff.

Learning Outcomes

In this session, you will:

  • Discuss the national standards related to PIVC
  • Examine the requirements of the standard for the management of PIVC 
  • Reduce unwarranted variation and improve the standard of care related to PIVC
  • Identify best practices for the management of PIVC
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