Standards of care for peripheral intravenous catheters: evidence-based expert consensus

Judy Thompson, MSNEd, RN, VA-BC, Association for Vascular Access, San Diego, CA.
Marlene M. Steinheiser, PhD, RN, CRNI, Infusion Nurses Society, Norwood, MA.
J Blake Hotchkiss, MSN, MBA, RN, VA-BC, MaineHealth Franklin Hospital, Farmington, ME.
James Davis, MSN, RN, CCRN-K, HEM, CIC, FAPIC, ECRI, Plymouth Meeting, PA.
Michelle DeVries, MPH, FAPIC, CPHQ, CIC, VA-BC, ICU Medical, San Clemente, CA.
Katie Frate, BSN, RN, VA-BC, St. Joseph's Children's Hospital, Tampa, FL.
Robert Helm, MD, Portsmouth Regional Hospital, Portsmouth, NH.
Chris W. Jungkans, BSN, BS, RN, VA-BC, CPUI, Advocate Health.
Swapna Kakani, MPH, Swapna Kakani Consulting, LLC, Huntsville, AL.
Sean Lau, MBA, BSN, RN, VA-BC, Stanford Health care, Palo Alto, CA.
Karen Lindell, DNP, RN, Moore Regional Hospital and FirstHealth of the Carolinas, Pinehurst, NC.
Kristen McNiff Landrum, MPH, KM Healthcare Consulting, Wilmington, NC.
Karen A. McQuillan, MS, RN, CNS-BC, CCRN, CNRN, TCRN, FAAN, American Association of Critical-Care Nurses, Aliso Viejo, CA; R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, MD.
D J. Shannon, MPH, CIC, VA-BC, FAPIC, IU Health Adult Academic Health Center, Indianapolis, IN.
Lorelle Wuerz, PhD, MSN, RN, VA-BC, NEA-BC, NewYork-Presbyterian Hospital, New York, NY.
Stephanie Pitts, DNP, RN, CPN, VA-BC, NEA-BC, B. Braun Medical Inc. Bethlehem, PA.

Abstract

BACKGROUND: The insertion of a PIVC is the most commonly performed invasive procedure in healthcare. Despite its frequency in placement in hospitalized patients, PIVCs are generally perceived as being safe; however, the prevalence of failure ranges from 35%-50%. Additionally, complications are common and often deemed 'acceptable' by clinicians. Healthcare provider and clinician foundational knowledge and competency is lacking nationally. Considering the mere volume of PIVCs placed, the failure and complication rates, the human impact is significant. METHODS: The Association for Vascular Access (AVA) has led a collaborative effort with representatives from the Infusion Nurses Society (INS), the American Association of Critical Care Nurses (AACN), ECRI, and content experts representing nursing vascular access, infusion therapy, infection prevention, critical care, pediatrics, healthcare leadership, a physician, and a patient representative. Our aim is to provide concise guidance that will enhance and standardize practices related to PIVC. By consolidating current standards of practice into a comprehensive document, our framework seeks to advance the quality of care and improve patient safety. RESULTS: This document has undergone meticulous scrutiny to ensure its quality, including incorporation of current standards, methodology for consensus from the expert panel, and input received from public comments. CONCLUSIONS: We anticipate that this work will have a significant impact on healthcare professionals, policymakers, and, most importantly, patients' experiences by the promotion of consistent, high-quality treatment, safety, and comfort for patients receiving a PIVC.