Safe and correct use of peripheral intravenous devices

Abstract

Background: A peripheral intravenous device (PIVD) provides venous access for the administration of medications, blood products and fluids. They can be associated with a risk of infection and other complications, which have prompted the development of evidence-based guidelines for their use at the Royal Adelaide Hospital (RAH). A previous audit performed at the RAH found unsatisfactory compliance with these guidelines across a group of wards. The Burns Unit performed poorly compared with other wards, but the reasons for this were not explored.

Methods: A repeat audit was performed for all PIVDs in the Burns Unit over a 3-week period and compliance with the PIVD safety guidelines was assessed. Factors influencing compliance were investigated and the evidence behind the guidelines was reviewed.

Results: Overall compliance with the seven safety criteria was 71%. Poorest compliance was for documentation of insertion date, which has implications for scheduling PIVD replacement.

Conclusion: The guidelines are largely evidence-based; however, not all of them are feasible for all patients within a hospital. The Burns Unit had an overall compliance rate of 71%. Auditing of individual wards is not effective in assessing those wards' compliance with the guidelines as many PIVDs are inserted in other locations in the hospital. For compliance to improve, other areas of the hospital where PIVDs are inserted need to be targeted.

Keywords: Burns Unit; audit; peripheral intravenous device; protocol compliance; safety.