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Hi all – We are revisiting our Peripheral IV management protocol a few years ago and removed the clause indicating that Peripheral IV’s needed to be removed at 72 hours. We use the VIP site rating which is documented each shift to monitor the site and guide removal option. We have not had any IV site infections to note since dropping the removal time frame.
The Centers for Disease Control and Prevention (CDC)’s 2011 guidelines state that it is not necessary to replace peripheral IV catheters in adults more than every 72 to 96 hours,3 but the CDC does not specify when the catheters should be replaced.
Direct copy from this guideline as below.
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 [36, 140, 141]. Category 1B
2. No recommendation is made regarding replacement of peripheral catheters in adults only when clinically indicated [142-144]. Unresolved issue
3. Replace peripheral catheters in children only when clinically indicated [32, 33]. Category 1B 4. Replace midline catheters only when there is a specific indication. Category II
6. Evaluate the catheter insertion site daily by palpation through the dressing to discern tenderness and by inspection if a transparent dressing is in use. Gauze and opaque dressings should not be removed if the patient has no clinical signs of infection. If the patient has local tenderness or other signs of possible CRBSI, an opaque dressing should be removed and the site inspected visually. Category II
7. Remove peripheral venous catheters if the patients develops signs of phlebitis (warmth, tenderness, erythema or palpable venous cord), infection, or a malfunctioning catheter [36]. Category IBI would be interested in thoughts from others and evidence for same if possible. In brief, I have been asked to provide evidence for our protocol.
Regards
Lesley Stewart
Infection Control CNC
Western District Health Service
Hamilton. Vic.MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
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Hi Lesley,
Im not sure of your timeframes and the urgency to your policy review BUT Safer Care Victoria through the Infection Control Network have recently commenced a project committee specifically looking at this topic. The product of that workgroup and project will likely provide statewide guidance for Victoria.
Kristy
National Standards Accreditation Lead
Ambulance VictoriaOn 18 Apr 2019, at 09:11, Lesley Stewart <Lesley.Stewart@wdhs.net> wrote:
Hi all We are revisiting our Peripheral IV management protocol a few years ago and removed the clause indicating that Peripheral IVs needed to be removed at 72 hours. We use the VIP site rating which is documented each shift to monitor the site and guide removal option. We have not had any IV site infections to note since dropping the removal time frame.
The Centers for Disease Control and Prevention (CDC)’s 2011 guidelines state that it is not necessary to replace peripheral IV catheters in adults more than every 72 to 96 hours,3 but the CDC does not specify when the catheters should be replaced.
Direct copy from this guideline as below.
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 [36, 140, 141]. Category 1B
2. No recommendation is made regarding replacement of peripheral catheters in adults only when clinically indicated [142144]. Unresolved issue
3. Replace peripheral catheters in children only when clinically indicated [32, 33]. Category 1B 4. Replace midline catheters only when there is a specific indication. Category II
6. Evaluate the catheter insertion site daily by palpation through the dressing to discern tenderness and by inspection if a transparent dressing is in use. Gauze and opaque dressings should not be removed if the patient has no clinical signs of infection. If the patient has local tenderness or other signs of possible CRBSI, an opaque dressing should be removed and the site inspected visually. Category II
7. Remove peripheral venous catheters if the patients develops signs of phlebitis (warmth, tenderness, erythema or palpable venous cord), infection, or a malfunctioning catheter [36]. Category IBI would be interested in thoughts from others and evidence for same if possible. In brief, I have been asked to provide evidence for our protocol.
Regards
Lesley Stewart
Infection Control CNC
Western District Health Service
Hamilton. Vic.MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
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MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
Replies to this message will be directed back to the list. To create a new message send an email to acipclist@acipc.org.au
To send a message to the list administrator send an email to admin@acipc.org.au
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