Quality Improvement Interventions for Peripheral Intravenous Catheter Nursing Practices: A Systematic Review.
Sumi Cho, Eun Man Kim
PMID 39999198WHAT IT FOUND
QI bundles, ultrasound guidance, and new devices reported fewer peripheral IV catheter complications and better nurse practice, but evidence is weak: few reported whether improvement was more than chance, and sustainability was often not reported.
Key findings
01The review included 27 studies, 15 focused on adults and 12 on pediatric patients.
02QI interventions fell into three types: ultrasound devices for insertion, new devices, and bundles for insertion and management.
03Eleven studies reported lower phlebitis or infiltration after intervention, but only one reported a statistically significant reduction.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
All included studies used one-group pretest/posttest designs, so before-after changes may reflect time or local factors rather than the intervention. Few studies reported statistical significance. Sustainability was met in only 13 of 27 studies, and spread or replication in only 10. The review included only English and Korean studies and excluded gray literature and theses. Costs were not reported. PIVC replacement and assessment guidelines varied across studies. Findings may not transfer to smaller hospitals with fewer resources.
The easy way to misread this
Do not read this as proof that PIVC bundles reduce complications. The included studies all compared the same group before and after, and only one study reported a statistically significant reduction in phlebitis or infiltration.