RNOtherNursing open2022

Evaluating peripheral intravascular catheter insertion, maintenance and removal practices in small hospitals using a standardized audit tool.

Alex Hoskins, Leon J Worth, Michael J Malloy and 3 others

PMID 35274830

WHAT IT FOUND

Peripheral IV catheter audits in small hospitals found bloodstream infection was 0% and phlebitis was 5.0%, but asepsis, hand hygiene and antiseptic documentation were missing for 45.9%, 46.1% and 43.9% of insertions.

Key findings

01Documentation was missing for whether aseptic technique was used, hand hygiene was performed, or an alcohol-based skin antiseptic was applied before insertion in 45.9%, 46.1% and 43.9% of audited PIVCs respectively.

02The VIP score was documented at least daily for 77.4% of PIVCs, and dressing assessment was documented at least daily for 52.0%.

03Among reported complications, phlebitis was 5.0% and bloodstream infection was 0%.

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

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What it does not show

Twelve of the fifteen audited hospitals had fewer than 100 beds, so the findings may not represent larger hospitals. Smaller facilities may have shorter patient stays and lower acuity, which can change PIVC use and dwell times. Clinical auditing was frequently retrospective, so missing records may reflect poor documentation rather than poor practice. The study describes practice and complication rates; it does not test an intervention or show that documentation changes improve outcomes. The paper does not state a single total number of PIVCs audited, so the reader must rely on category counts and percentages.

Declared interests

The authors declare no conflict of interest. The supplied article metadata lists non-U.S. government research support, but the text does not name a funder or describe sponsor involvement.

The easy way to misread this

Do not read the 0% bloodstream infection and 5.0% phlebitis rates as proof that PIVC care is safe overall. This was an audit of mostly small hospitals, and missing records may reflect poor documentation rather than poor practice.

Read it on PubMed →