A Short Peripheral Intravenous Catheter (short PIVC) is “an over-the-needle catheter with a hollow metal stylet (needle) positioned inside the catheter, generally inserted in superficial veins”.
The insertion of a short PIVC is a widely preformed and invasive procedure in the acute care setting. PIVCs are associated with high rates of complications such as phlebitis, dislodgement, infiltration, occlusion, and catheter bloodstream infection. These complications can lead to patient discomfort and add substantially to treatment costs. With a high failure rate of PIVCs, there is a need for greater consistency in the choice, insertion, and management of short PIVCs. It is suggested to define a bundle strategy for short PIVCs that might improve the outcomes of this type of vascular access device.
A care bundle is a set of evidence-based interventions, when used together in a single protocol, significantly improve patients’ outcomes. It is important to create a bundle based on policy, procedure, and materials, INS and CDC standards, insertion care and maintenance, and dwell times and removal guidelines.
- Hand washing prior to catheter insertion with either a waterless, alcohol-based product or an antibacterial soap and water with adequate rinsing.
- Cleansing the skin with 0.5% chlorhexidine, in alcohol.
- There is no replace peripheral catheters more frequently than every 72-96 hours to reduce the risk of infection and phlebitis in adults.
- No recommendation is made regarding replacement of peripheral catheters in adults only when clinically indicated.
- Insert PIVC via the forearm vessel to prolong the dwell time, increase the likelihood of the PIVC lasting the full length of the prescribed therapy, decrease the pain during the dwell time, promote self-care, and prevent accidental removal and occlusions.
- Choose veins found on the dorsal and ventral surfaces of the upper extremities including metacarpal, cephalic, basilic, and median veins.
- Consider hand veins for short term therapy. PIVC insertion in areas of flexion such as the hands associated with higher rates of failure over time.
- Consider the use of external jugular vein in patients in acute care settings and in emergency situations when other veins cannot be accessed, collaborate with the provider for an alternative vascular access site as soon as possible.
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Bertoglio S, van Boxtel T, Goossens GA, et al. Improving outcomes of short peripheral vascular access in oncology and chemotherapy administration. The Journal of Vascular Access. 2017;18(2):89-96. doi:10.5301/jva.5000668
Centers for Disease Control and Prevention. (2015, November 5). Recommendations. Centers for Disease Control and Prevention. Retrieved October 14, 2021, from https://www.cdc.gov/infectioncontrol/guidelines/bsi/recommendations.html.
Gorski LA, Hadaway L, Hagle ME, et al. Infusion therapy standards of practice. J Infus Nurs. 2021;44(suppl 1):S1S2-S224. Doi:10.1097/NAN.0000000000000396