Peripheral IV Site Change When Clinically Indicated vs. Customary Practice of Every 96 Hours

Apel, Stacey
Brucker, Nicole
Bond, Jennifer
Weitzel, Tina
Chamberlain, Jill

Stacey Apel, MSN, RN, CNL, is Cardiac Nurse and Nursing Practice Council Member, Memorial Medical Center, Springfield, IL.

Nicole Brucker, BSN, RN, CCRN, is Post-Surgical Care Unit Nurse, Nursing Practice Council Chair, Memorial Medical Center, Springfield, IL.

Jennifer Bond, DNP, RN, NE-BC, is Vice President of Nursing, Memorial Medical Center, Springfield, IL.

Tina Weitzel, MA, RN, RN-BC, is Nursing Outcomes Improvement Facilitator, Memorial Medical Center, Springfield, IL.

Jill Chamberlain, PhD, RN, NE-BC, is Manager, Nursing Research and Academic Partnerships, Memorial Medical Center, Springfield, IL.

MEDSURG Nursing 30(2):p 103-107, March-April 2021.

Routine replacement of peripheral intravenous (IV) catheters causes dissatisfaction among patients, creates poor use of nursing time, and increases cost to the organization. An evidence-based practice project initiated by a nursing shared governance council demonstrated no significant difference (p=0.318) in phlebitis rates between IVs changed every 72-96 hours and when clinically indicated.

Clinical Question

In adult, acute care patients, does leaving an intravenous (IV) line intact until removal is clinically indicated (end of therapy, redness, occlusion, or leakage) versus the customary practice of changing the IV after 96 hours of dwell time impact rates of phlebitis?

Evidence-Based Practice Model

Revised Iowa Model ()

Patient Outcomes

The primary outcome measure for this study was incidence of phlebitis (measured as percent of IV catheters that developed signs or symptoms of phlebitis). The defined phlebitis as the presence of pain, tenderness, erythema, warmth, swelling, induration, purulence, or palpable venous cord.

Search Strategy

Keywords for the literature search included peripheral venous catheters, dwell time, catheter-related infections, phlebitis, and complication for 2016-2020. Exclusion criteria included pediatric patients, midline catheters, central lines, and securement devices. After 67 articles were retrieved initially, researchers’ review for relevancy to this project led to selection of 11 articles.

Databases

CINAHL, Clinical Key in Nursing, and PubMed

Clinical Setting

Acute care patients in a 500-bed Magnet^®-designated, Level 1 trauma hospital in the midwestern United States