Peripheral Intravenous Catheter Care in Australian Emergency Departments: Are We Meeting Standards?

Peripheral intravenous catheters (PIVCs) are one of the most commonly used medical devices in emergency departments (EDs), yet adherence to best practices remains inconsistent. A recent cross-sectional observational study investigated how well Australian ED clinicians follow the PIVC Clinical Care Standard introduced in 2021. The findings reveal significant gaps in practice, emphasizing the need for improvement in patient partnership, insertion techniques, and documentation.

Study Overview
The study was conducted across three Australian EDs between 2022 and 2023, auditing 1,568 episodes of PIVC care. Researchers evaluated bedside insertion practices, maintenance, and documentation quality against national guidelines.

Key Findings
1. Minimal Patient Engagement:

Only 1.4% of patients received self-care education about their PIVC.
Only 2.9% of clinicians discussed potential risks and benefits before insertion.

2. Insertion Challenges & High Failure Rates:

Most insertions (81.2%) occurred at the antecubital fossa, a site associated with higher failure rates.
More than 56% of insertions did not allow sufficient drying time for antiseptic solution, increasing infection risks.
41.8% of PIVCs were inserted but never used, highlighting inefficiencies.

3. Poor Documentation:

Only 27.3% of inpatient ward admissions had clear justification for PIVC use.
Insertion details (e.g., number of attempts, removal times) were frequently missing from patient records.

Implications for Clinical Practice
These findings highlight the need for:
- Better patient education to promote engagement and informed decision-making.
- Stronger adherence to antiseptic drying times to minimize infection risks.
- Improved documentation and justification for PIVC insertion to prevent unnecessary procedures.

Conclusion
Despite the introduction of national standards, significant gaps in PIVC care remain in Australian EDs. This study underscores the need for ongoing training, process improvements, and the integration of new technologies to enhance patient safety and optimize vascular access care.

Read More:https://onlinelibrary.wiley.com/doi/10.1111/jan.16810 

Authors: Hui (Grace) Xu, Anna Doubrovsky, Claire M. Rickard, Lauryn Rockliff, Christopher Tang, Amanda J. Ullman