Prof. Nicole Marsh1,2,3, Ms. Emily Larsen1,3, Professor Amanda Ullman2,4, Dr Gillian Ray-Barruel2,5, Dr Gabor Mihala2, Professor Claire Rickard2,5
1Royal Brisbane and Women's Hospital, Herston, Australia, 2The University of Queensland, St Lucia, Australia, 3Griffith University, Nathan, Australia, 4Children's Health Queensland Hospital and Health Service, South Brisbane, Australia, 5Herston Infection Disease Institute, Metro North Health, Herston, Australia
Biography:
Professor Nicole Marsh is the Nursing and Midwifery Director for Research at the Royal Brisbane and Women’s Hospital. Her program of research is focused on improving patient outcomes and decreasing complications associated with vascular access across the acute care and community setting. She is currently leading a team who are investigating the clinical and economic benefit of different workforce models for vascular access device insertion to improve patient outcomes. In recognition of her expertise in the field, she was invited to advise on the Australian Commission on Safety and Quality in Healthcare’s 2021 Peripheral Intravenous Catheter Clinical Care Standard.
Abstract:
Introduction
Peripheral intravenous catheters (PIVC) are the most common invasive medical device in hospitals, yet they are frequently associated with complications. This systematic review was undertaken to determine the prevalence of PIVC infections and all-cause failure.
Methods
A systematic search was conducted on the 26th of August 2022 in the Cochrane Library, PubMed, CINAHL, and EMBASE for observational studies and randomised controlled trials (RCTs) that reported PIVC infections or failure. Studies published in English since the year 2000 were included. Pooled estimates were calculated with random-effects models. Meta-analysis of observation studies in epidemiology guidelines and the Cochrane process for RCTs were used to guide the review.
Results
Database searches returned 34,725 studies, of these 41 observational and 28 RCTs were included (478,586 PIVCs). The pooled proportion of catheter-associated bloodstream infections (CABSI) was 0.028 % (95 % confidence interval (CI): 0.009–0.081; 38 studies), or 4.40 CABSI per 100,000 catheter-days (20 studies, 95 % CI: 3.47–5.58). Local infection occurred in 0.150 % PIVCs (95 % CI: 0.047–0.479, 30 studies) with an incidence rate of 65.1 per 100,000 catheter-days (16 studies; 95 % CI: 49.2–86.2). In total 36.4 % of PIVCs failed (95 % CI: 31.7–41.3, 53 studies) with an incidence rate of 4.42 per 100 catheter days (78,891 catheter days; 19 studies; 95 % CI: 4.27–4.57).
Conclusions
One in three PIVCs are failing globally and although PIVC infection occurrence is low, it remains a high burden with over 2 billion PIVCs purchased every year.