Dr Gillian Ray-Barruel1,2,3,4, Prof Nicole Marsh3,4, Ms Emily Larsen3,4, Prof Amanda Ullman2,3,5, Ms Tricia Kleidon2,5, Ms Mari Takashima3,5, Dr Vineet Chopra6,7, Prof Claire Rickard1,2,3,4
1Herston Infectious Diseases Institute, University of Queensland Centre for Clinical Research, Herston, Australia
2School of Nursing, Midwifery and Social Work, The University of Queensland, St Lucia, Australia
3School of Nursing and Midwifery, MHIQ, Griffith University, Nathan, Australia
4Royal Brisbane and Women’s Hospital, Herston, Australia, 5Queensland Children’s Hospital, South Brisbane, Australia
6University of Michigan Medicine, and Michigan Hospital Medicine Safety Consortium, Ann Arbor, U.S.A.
7University of Colorado Medicine, Anschutz, U.S.A.
Introduction: Prevalence audits demonstrate up to 50% of peripheral intravenous catheters (PIVCs) are left in situ when no longer required for medical treatment. However, prevalence audits do not capture outcome data, and therefore any associated complications during idle catheter dwell are unknown. The aim of this study was to identify the prevalence of idle catheters and subsequent outcomes.
Methods: We undertook a secondary analysis of previously collected de-identified data from adult and paediatric patients from 4 randomised controlled trials and 2 observational studies evaluating technologies and outcomes of PIVCs in acute hospital settings. We analysed every catheter from insertion until removal. Idle catheter was defined as no intravenous medication or fluid in the past 24 hours or more.
Results: A total of 3677 patients with 4565 PIVCs were included in the analysis, and 844 catheters were idle for >24 hours. Idle catheter rates were as follows: Day 1, 114/832 (13.7%); Day 4, 127/655 (19.4%); Day 7, 40/104 (38.5%). By specialty, most idle catheters were in medical patients (41.6%), followed by elective surgery patients (29.9%). In total, 698/844 (82.1%) idle catheters were inserted in the ward environment, and 147/844 (17.4%) had required 2 or more insertion attempts.
Conclusion: Idle catheters are prevalent in acute care settings, with implications for adverse patient outcomes (complications, bloodstream infection, extended hospital stay) and healthcare costs (catheter resources, nursing time). A greater awareness of the risks of idle catheters could improve patient safety. Implementation of a daily reminder to remove idle catheters is strongly recommended.
Biography: Gillian Ray-Barruel, RN PhD, is a Senior Research Fellow with The University of Queensland School of Nursing, Midwifery and Social Work, and Herston Infectious Diseases Institute (HeIDI). She is also the Director of Education with the Alliance for Vascular Access Teaching and Research (AVATAR), based at Griffith University. Her research focuses on improving assessment and decision-making by nurses to prevent patient complications and improve patient safety and healthcare outcomes.