Prof. Claire Rickard1,2,3,4, Dr Jessica Schults1,2,3, Dr Gabor Mihala5,6, Ms Emily Larsen3,4, Professor Nicole Marsh1,3,4, Dr Naomi Runnegar7,8, Ms Tricia Kleidon1,3,4,9,12, Professor Amanda Ullman1,3,4,9,12, Professor Samantha Keogh3,4,10, Ms Daner Ball1,2,3, Dr Amanda Corley1,3,4, Dr Simon Bugden11, Dr Gillian Ray-Barruel1,2,3
1School of Nursing, Midwifery and Social Work, The University of Queensland Centre for Clinical Research, Herston, Australia, 2Herston Infectious Diseases Institute, Metro North Health, Herston, Australia, 3Alliance for Vascular Access Teaching and Research, Schools of Nursing and Midwifery and Pharmacy and Medical Sciences, Southport, Australia, 4Nursing and Midwifery Research Centre, Royal Brisbane and Women’s Hospital, Herston, Australia, 5Centre for Health Services Research, The University of Queensland, Brisbane, Australia, 6Australasian Kidney Trials Network, The University of Queensland, Brisbane, Australia, 7Princess Alexandra Hospital, Metro South Hospital and Health Service, Woolloongabba, Australia, 8The University of Queensland, St Lucia, Australia, 9Queensland Children’s Hospital; Children’s Health Queensland Hospital and Health Service, South Brisbane, Australia, 10School of Nursing and Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, Australia, 11Metro North Hospital and Health Service , Brisbane, Australia, 12Children’s Health Research Centre, University of Queensland, South Brisbane, Australia
Biography:
Professor Claire Rickard is a leading nurse researcher in vascular access and infection prevention. She founded AVATAR, leads major global studies, has over 300 publications, and mentors emerging researchers. Her work, including 50+ Randomised Controlled Trials, is internationally recognised, earning her prestigious awards and consistent national research funding.
Abstract:
Background
Peripheral intravenous catheters (PIVCs) are commonly used in hospitalised patients but can be a source of bloodstream infections (BSIs), contributing to significant morbidity and mortality. However, precise risk estimates for PIVC-associated infections remain unclear.
Objectives
To quantify the incidence of peripheral intravenous catheter (PIVC) infections and to describe the influence of clinical characteristics, including dwell time, on risk.
Methods
Meta-synthesis of 18 prospective studies reporting PIVC infections. A total of 14,606 PIVCs (50,096 device-days) were studied in seven Australian government hospitals. We calculated the incidences and rates of local infection and PIVC-associated bloodstream infection using National Healthcare Safety Network criteria. The hazard function was assessed by fitting a parametric survival model. PIVC-associated BSI was categorised as PIVC-related BSI and/or Staphylococcus aureus BSI. Case study methodology explored characteristics of PIVC-associated BSI, and life tables explored the hazard function of PIVC-associated BSI over dwell time.
Results
Of 14,606 PIVCs (dwell 0–42 days), there were five local infections (0.034%; 0.100/1,000 device-days) and six PIVC-associated BSI (0.041%; 0.120/1,000 device-days). PIVC-associated BSIs commonly featured: males >60 years with difficult intravenous access, delayed removal of idle or symptomatic PIVCs, cancer diagnoses, invasive gastrointestinal drains/procedures, insertion site complications, and forearm placement. PIVC-associated BSI daily hazard was constant over time with zero to 0.03% on Days 1 to 5 (n=11,491), 0.06% to 0.10% on Days 6 and 7 (n=2,571), and zero on Days 8 to 42 (n=544).
Conclusions
Infection incidence is low but remains a serious risk, particularly for complex patients. Suggesting surveillance should be risk-adjusted.