1 in 5 catheters unnecessarily painful or malfunctioning

A global study has found major problems with the manner in which short peripheral catheters are managed, with two-thirds of catheter insertions found to be placed in non-recommended sites or at risk of failure, and one in five catheters found to be unnecessarily painful or malfunctioning.

The study, led by Western Sydney University, involved hundreds of health professionals who assessed 40,620 peripheral intravenous catheters (PIVCs) in 51 countries. The study found that thousands of catheters were placed in non-recommended sites such as the hand, wrist or antecubital veins with many devices reviewed already failing or at risk of failure.

Lead author Dr Evan Alexandrou from Western Sydney University’s School of Nursing and Midwifery and Liverpool Hospital, said the findings highlight inconsistencies in published recommendations.

“For something so commonly used, failure rates are unacceptably high. We found one in five catheters to be painful or otherwise symptomatic, with dressings covering the catheters being substandard and many devices were idle and had not been used for some time,” he said.

“Nearly half the catheters reviewed had no documented date or time of when the devices were inserted.

“To put this problem into perspective, almost 2 billion PIVCs are used annually around the globe. This means millions of patients around the world have painful or malfunctioning catheters that staff have not responded to.”

Beyond avoiding painful catheter insertion, Dr Alexandrou said better practice with PIVC management would have health and financial benefits. “It would reduce delays in treatment with vital medication, improve efficiency of diagnostic tests such as laboratory values where blood sampling is required and also improve catheter infection rates,” Dr Alexandrou said. “The financial benefit to the Australian healthcare system alone would be in the millions of dollars.”

Dr Alexandrou hopes this study will highlight the inconsistencies between published best practice guidelines and current management practices of PIVCs, and the need to have a more proactive approach to the management of these devices.

“The findings suggest that additional training and technology are required so that staff can better identify and insert PIVCs effectively. Further, a stronger focus is needed on compliance with PIVC insertion and management guidelines; better surveillance of PIVC sites; and improved assessment, decision-making, and documentation,” Dr Alexandrou said.

The study, Use of Short Peripheral Intravenous Catheters: Characteristics, Management, and Outcomes Worldwide, has been published in the Journal of Hospital Medicine. It was co-authored by Liverpool Hospital, Griffith University, University of Western Australia, University of New South Wales, Royal Berkshire Hospital, Queensland University of Technology, Rhode Island Hospital, Brown University, as well as multiple study collaborators in each country.

Image credit: ©stock.adobe.com/au/Photographee.eu