Replacing intravenous catheters only when clinically necessary is safe and could save

September 20, 2012

New research published in the third Article in The Lancet surgery-themed issue suggests that the millions of intravenous catheters used each year can be safely changed only when clinically necessary, overturning 40 years of accepted practice involving routine replacement every 3 days. Introducing such a policy would not only prevent unnecessary painful procedures in one fifth of patients but also dramatically reduce equipment and staff costs.

"Of the 200 million catheters estimated to be inserted each year in the USA alone, if even 15% are needed for more than 3 days, then a change to clinically required replacement would prevent up to 6 million unnecessary intravenous catheter insertions, and would save about 2 million hours of staff time, and up to US$60 million in each year for that country alone", explains Claire Rickard from Griffith University in Australia who led the research.

In the study, 3283 adult patients expected to require a catheter for longer than 3 days were enrolled from three hospitals in Queensland, Australia. Patients were randomly assigned to either clinically indicated or routine removal every 3rd day to compare the effectiveness of each practice at reducing infection and phlebitis (inflammation of the vein).

The average catheter dwell time was 99 hours in the clinically indicated group and 70 hours in the routine replacement group. Phlebitis occurred in 7% of patients in both groups, blood-stream infections were rare and did not differ between groups, and no local infections were reported in either group.

According to Joan Webster, the senior author from Royal Brisbane and Women's Hospital in Australia, "Up to 70% of hospitalised adult patients need a peripheral intravenous catheter. Catheter replacement is costly, time consuming, and causes distress to patients. Our data strongly suggest that routine replacement does not reduce complications, but rather causes many unnecessary . Updated intravenous catheter policies (including CDC guidelines for ) should advocate clinically indicated removal."

Writing in a linked Comment, Donna Gillies from Western Sydney Local Health District, Australia and Elisabeth O'Riordan from The Children's Hospital at Westmead, Australia say, "A major finding of this study was the high proportion of catheter failures, at nearly 30%. The failure of catheters due to infiltration, occlusion, or accidental removal was far more frequent than phlebitis or infection. Therefore, future studies that identify means of prevention of such failures might have even greater implications for cost, reduction of unnecessary invasive procedures, and staff workloads than the present findings."

Explore further: Antimicrobial catheters could save NHS millions

More information: www.thelancet.com/journals/lan … (12)61082-4/abstract

Related Stories

Antimicrobial catheters could save NHS millions

March 27, 2012
A new catheter coating that reduces bacterial attachment to its surface is being developed by scientists who are reporting their work at the Society for General Microbiology's Spring Conference in Dublin this week. The antimicrobial ...

Acne-treating antibiotic cuts catheter infections in dialysis patients

August 19, 2011
Antibiotics can help ward off serious bacterial infections in kidney disease patients who use tubes called catheters for their dialysis treatments. But if antibiotics are used too often, "super bugs" may crop up that are ...

Peripheral venous catheters pose infection risk

May 3, 2011
A new study from Rhode Island Hospital has found that more than one in 10 catheter-related bloodstream infections due to Staph aureus in hospitalized adults are caused by infected peripheral venous catheters (PVC). The study ...

'Smart catheters' for the major problem of catheter-related infections

August 23, 2012
A new "smart catheter" that senses the start of an infection, and automatically releases an anti-bacterial substance, is being developed to combat the problem of catheter-related blood and urinary tract infections, scientists ...

Killer infections targeted by hospital study

August 3, 2012
A major international study led by University of Adelaide researchers aims to prevent death and serious illness caused by one of the most common infections contracted by patients in hospitals.

Recommended for you

Surgeons have major influence on breast cancer treatment

September 13, 2017
A woman's choice of surgeon plays a significant role in whether she's likely to receive an increasingly popular aggressive breast cancer surgery.

Some thyroid cancer patients can safely delay surgery

September 4, 2017
Most people diagnosed with cancer want to start treatment as soon as possible, for fear that delaying care will allow their tumor to grow out of control.

Obese people lack cells with satiety hormones

August 29, 2017
Individuals with severe overweight have an inhibited sense of satiation - they release fewer satiety hormones than people of normal weight. The reason: the responsible cells in the gastrointestinal tract of obese people are ...

Anesthesia and surgery during infancy may impact white matter during childhood

August 24, 2017
General anesthesia and surgery in otherwise healthy infants under the age of 1 year old could be associated with decreases in the amount of white matter in the brain, as well as reductions in the remaining white matter's ...

Smoking raises risk of aneurysm recurrence after endovascular treatment

August 17, 2017
In a new study, researchers report people who have experienced an aneurysm have another reason to quit smoking.

Study adds to evidence that most prescribed opioid pills go unused

August 2, 2017
In a review of half a dozen published studies in which patients self-reported use of opioids prescribed to them after surgery, researchers at Johns Hopkins report that a substantial majority of patients used only some or ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.