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Clinically indicated replacement versus routine replacement of peripheral intravenous catheters: a quality improvement project comparing phlebitis rates
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Galluzzo, Karen. Clinically indicated replacement versus routine replacement of peripheral intravenous catheters: a quality improvement project comparing phlebitis rates. Retrieved from https://doi.org/doi:10.7282/t3-a3he-dp59

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TitleClinically indicated replacement versus routine replacement of peripheral intravenous catheters: a quality improvement project comparing phlebitis rates
NameGalluzzo, Karen (author); Prado, Kimberly (chair); Rutgers University; RBHS School of Nursing
Date Created2023
Other Date2022-11-29
Other Date2023-01 (degree)
SubjectNursing, Clinically indicated, IV replacement, Peripheral intravenous catheter, PIV, PIV dwell time, Rotating PIV
Extent37 pages : illustrations
DescriptionPURPOSE: Peripheral intravenous catheter insertion is the most common invasive procedure for hospital inpatients. Guidelines developed by the CDC are outdated and recommend PIVs be changed every 3 days. This DNP project aims to determine if implementing a QI project allowing PIVs to remain in-situ until no longer clinically viable will increase phlebitis rates.
METHODOLOGY: A hospital-wide QI project was initiated in a NJ hospital. Recruitment involved use of the EMR, sampling 30 patients pre and post-implementation for a retrospective chart review. The evaluation focused on phlebitis scores, comparing those left in-situ both less and more than 96 hours. Information on the policy change was disseminated using an email practice flash and flyers were posted in each clinical unit. Infection prevention rounded to reinforce the change, and orientation of new hires incorporated the change into their training. Factors for exclusion were age less than 18 years, diagnosis of sepsis, catheters placed in the field, and vesicant infusate.
RESULTS: The rates of phlebitis for PIVs allowed to remain in-situ until no longer clinically viable did not increase after implementation of the QI project but is inconclusive due to a lack of data points in the nursing documentation. 95% of the charts did not have a documented reason for removing the line before 30 days. 20% had no removal date or time listed. 40% had vesicants infusing, but 100% did not have the infusing medication linked to the line it was running through.
IMPLICATIONS FOR PRACTICE: The recommendation for routine replacement of PIVs should be reevaluated, considering the increased compliance of nursing sterile technique and the innovations of PIV materials, while also noting the additional cost and discomfort for the patient. A limitation of the study is that although phlebitis scores were listed as zero, the reason for early line removal was not documented. Another limitation of the data collection was the inability to accurately incorporate the project’s exclusion criteria, due to a lack of line linking. These limitations will positively impact the importance of nursing documentation, PIV assessment skills, the need for advanced ultrasound-guided lines, and IV fluid site line linking.
NoteD.N.P.
NoteIncludes bibliographical references
Genretheses
Persistent URLhttps://doi.org/doi:10.7282/t3-a3he-dp59
LanguageEnglish
CollectionSchool of Nursing (RBHS) DNP Projects
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.
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