Re: Routine resite of peripheral intravinous devices

[Tim Spencer]

Hi Franciska,

At Liverpool we do not have a peripheral IV Team (would solve many
issues if we did), however, our current policy is based around the
current EBP literature of 72hrs (please check the “Clinically-indicated
replacement versus routine replacement of peripheral venous catheters –
Cochrane Review” by Webster, Osborne, Rickard and Hall 2010) for more
information.

We have been looking at incorporating the VIP Scoring system (Andrew
Jackson – Rotherham NHS, UK) into our policy to allow for an
appropriately placed IV cannulae to remain insitu longer than 72hrs
should there be no sign of local inflammation, redness, induration,
swelling, infiltration or extravasation on daily shift checks.

Emergently placed cannulae should be replaced at the very earliest
convenience or at 24hrs (whichever comes first).

The other point to consider is that if a patient requires more than 3
cannulae for their intended therapy, then a more appropriate device
should be placed i.e midline, PICC, CVC

This decision should be based around what we call the 5 Rights of
Vascular Access which determines the following steps;

The ‘RIGHT’ trained clinician will insert,

The ‘RIGHT’ vascular device in the,

The ‘RIGHT’ vessel for the,

The ‘RIGHT’ patient at the,

The ‘RIGHT time.

Vessel Health and Preservation should be at the top of the list in
regards to vascular access issues, regardless of the device being
placed.

Feel free to contact me if you need.

Tim..

Timothy R. Spencer, RN, APN, DipAppSci, Bach.Health, ICCert.
Clinical Nurse Consultant, Central Venous Access & Parenteral Nutrition
Service

Conjoint Lecturer, South West Sydney Clinical School | Faculty of
Medicine | University of NSW
Dept of Intensive Care, Level 2, Clinical Building, Liverpool Hospital,
Elizabeth Street, Liverpool, 2170, NSW, Australia
Tel (+61) 2 8738 3603 | Fax (+61) 2 8738 3551 | Mob +61 (0)409 463 428 |
Tim.Spencer@sswahs.nsw.gov.au | Timothy.Spencer@unsw.edu.au

Behalf Of Franciska Ferreira

Good Morning to you all,

Our current Peripheral Intravenous Cannulation policy states; to resite
a IV cannula every 72 hours. I know there is some debate on this issue
and recent evidence suggests routine resite is unnecessary. Current
recommendations are to resite IV Cannulas every 96 hours with the
exception of children and patients with poor veins. Saying that, not
all Hospitals has IV teams to resite all the necessary IV cannulas.

Could you please let me know if any of your organizations have an IV
Team and when do you routinely resite patients cannulas?

Kind Regards

Franciska Ferreira

INFECTION PREVENTION & CONTROL /WOUND MANAGEMENT CONSULTANT

Burnside War Memorial Hospital

120 Kensington Road, Toorak Gardens, SA 5056

t: 08 8202 7222 f: 08 8407 8573 e: fferreira@burnsidehospital.asn.au

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