Best practice in the use of peripheral venous catheters: A scoping review and expert consensus

Infect Prev Pract. 2023 Feb 3;5(2):100271. doi: 10.1016/j.infpip.2023.100271. eCollection 2023 Jun.

Abstract

Background: Peripheral intravenous catheters (PIVCs) are the most commonly used invasive medical device in health care with an overall failure rate of 35-50%. Most complications are non-infectious, but local site and bloodstream infections can also occur. Even if PIVC-related infections are rare, the total number of affected patients and the preponderance of Staphylococcus aureus as related pathogen due to the frequent use of these devices are relevant arguments to implement preventive strategies. The aim of this document is to raise awareness that infections caused by PIVCs are a relevant problem that can be reduced by practice change.

Methods: A panel of experts discussed this topic based on evidence and proposed practice points by consensus.

Discussion: Despite published evidence-based guidelines, current practice concerning aseptic techniques during insertion and care of PIVCs often are substandard. These devices have become commonplace and tend to be perceived as safe. An overall lack of awareness about the true risks associated with the use of PIVCs results in limited surveillance and prevention efforts.

Conclusion: Successful insertion and maintenance bundles in central venous lines are a blueprint to the implementation of adapted bundle strategies in the prevention of PIVC-associated infections. There is a need for studies to specifically investigate infection prevention in PIVCs and to agree on effective and implementable bundles.

Keywords: A-DIVA, Adult difficult intra venous access; BSI, Bloodstream infection; Best practice; Bloodstream infections; CHG, Chlorhexidine gluconate; CRBSI, Catheter-related bloodstream infection; Complications; ERPIUP, European Recommendations for Proper Indication and Use of Peripheral venous Access; Exit-site infections; IV, Intravenous; PIVC, Peripheral intravenous catheter; Peripheral venous catheter; Prevention.