Peripheral Intravenous Catheter (PIVC) Complications

How often do your facilities change peripheral intravenous catheters (PIVCs)?TroubleHas it become?
"I just refilled it and it's already clogged." "It's swollen again." "I wonder how many I've gone through today..." Isn't this kind of experience something you encounter daily on the job?
Here's what I'll be introducing this time:Realities of PIVC Infections and MalfunctionsThis is a meta-analysis that revealed this from 69 studies and approximately 480,000 data points.

Peripheral intravenous catheter infection and failure: A systematic review and meta-analysis
Marsh N, et al. International Journal of Nursing Studies 151 (2024) 104673

Background
Peripheral intravenous catheters (PIVCs) are the most frequently used invasive devices in nursing practice, but they often cause complications. This study conducted a systematic review and meta-analysis to clarify the prevalence of PIVC-related infections and all-cause complications.

Method
We searched the Cochrane Library, PubMed, CINAHL, and EMBASE for observational studies and randomized controlled trials (RCTs) reporting infections or complications related to PIVCs. The search was limited to English-language articles published since 2000. Pooled estimates were calculated using a random-effects model, and analyses were conducted according to the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines for observational studies and Cochrane’s processes for RCTs.

Result
The search identified 34,725 publications, and ultimately 41 observational studies and 28 RCTs (totaling 478,586 PIVCs) were selected. The pooled rate of catheter-associated bloodstream infections (CABSI) was 0.028%(95% CI: 0.009–0.081, 38 studies), and the incidence rate was 4.40 cases per 100,000 catheter-days (95% CI: 3.47–5.58, 20 studies).The pooled prevalence of local infections was 0.150% (95%CI: 0.047–0.479, 30 studies), and the incidence rate was 65.1 cases per 100,000 catheter-days(95% CI: 49.2–86.2, 16 studies).PIVC malfunctions prior to completion of treatment occurred at a rate of 36.41 TP3T (95% TP3TCI: 31.7–41.3, 53 studies), and the overall incidence rate was 4.42 events per 100 catheter-days(95% CI: 4.27–4.57, 19 studies).

Examination and Conclusion
PIVC malfunction is a worldwide serious problem, with one in three failing before treatment completion. Although infection rates per catheter are low, given that over 2 billion are used globally each year, the absolute number of infections and the associated healthcare burden remain significant. Furthermore, the CABSI rate presented in this review (0.044 per 1000 catheter-days) is significantly lower than previous reports (0.5), establishing a new benchmark. The first meta-analysis of local infections revealed insufficient reporting of any infectious outcome between studies. To reduce PIVC infections and malfunctions, multifaceted, system-wide organizational efforts are essential, including enhanced education on insertion and management, vessel preservation through appropriate device selection, and promoting early removal using validated clinical judgment tools.

NOTE

Peripheral Intravenous Catheter (PIVC) Complications | Japan Intravenous Catheter Research Association (J-IVCARES) How often do peripheral intravenous catheters (PIVCs) cause problems at your facility? "It's already clogged even though I just inserted it," "It's swollen again," "How many have I put in today...".