Peripheral intravenous catheter performance: investigating peripheral intravenous catheter dwell times

Abstract

Background: The recording and reporting of peripheral intravenous (PIV) line failures is not commonly carried out in South Africa. Statistics are collected on pressure ulcers, catheter-related bloodstream infections or phlebitis, but not on PIV catheter infiltration. Currently, there are no data on the rate of unscheduled restarts due to PIV catheter failures in South Africa. Method: A small, two-phased study was conducted in one ward. The rate of PIV catheter line complications, and current practices with regard to PIV catheter insertion and maintenance, were investigated in Phase 1. PIV catheter failure rates with regard to a new PIV catheter securement dressing were investigated in the second phase. The results of the two phases were compared to try and establish whether or not the implementation of an advanced securement dressing versus the standard flat transparent film dressing minimised complication rates and unscheduled restarts. Results: Data collected in phase 1, using current practices and a standard flat transparent film dressing, showed that 21% of the PIV catheters failed due to infiltration and had to be restarted. After the implementation of a new PIV catheter securement dressing, the infiltration rate decreased to 1.7%, resulting in significant cost savings. This small study showed that better securement minimised unscheduled restarts and could reduce costs. Further studies are required to raise awareness of PIV catheter failure rates and the unnecessary cost that accompanies unscheduled restarts. Conclusion: Limited reporting of PIV catheter infiltration results in scant statistics regarding these incidences. It will be of value to record and report incidences of PIV catheter line infiltration and seek solutions to minimise complications. Catheter stabilisation devices help secure and preserve the integrity of devices, minimise movement, prevent catheter dislodgment, and help to reduce the risk of complications caused by intravascular devices.