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Removal of peripheral IV.

Hi Team. Just returned from Global IV Leadership summit…amazing learning. Can you please tell me what the stance in Britain is for removal of peripheral IV. Is it as clinically indicated…using the VIP score to guide or is it still 72-96 hours. INS support clinically indicated removal…but my hospital here in NZ are reluctant even tho Claire Rickards research is very positive towards clinical indication removal.
Cheers
Bev NZ


In: general, Posted 5 years ago

By: Level Rating Level Rating3 points

2 Answers

Answer #1

As things stand at the moment in the UK timeline wise Calire’s paper was published in the Lancet in Sept 2013 and then included in epic3 guidance as a category 2 recommendation – these were published in .
Jan 2014 – it remains to be seen whether folk will incorporate this evidence based practice into their local policies
I have had discussions with various clincians who have said they would not change their practice or policies. It is interesting to note that the following is a direct quote from the epic3 document. The epic3 process has an accreditation from NICE

“These recommendations are
not detailed procedural protocols, and need to be incorporated
into local guidelines. None are regarded as optional.”

Answers Answered By: sheilainwood Level Rating2 points
Answer #2

In principle, I agree fully with the recommendation that peripheral cannulae are re-sited when clinically indicated. However, I’m sure we can all list ‘patient’ and ‘medication’ combinations that often result in early disfunction of the peripheral cannula. Putting aside alternative vascular access device choices for a moment, I would rather see a patient and medication specific approach. If we anticipate potential problems based on topics such as diagnosis, medication, device and infusion history (e.g. previous phlebitic episodes) it is likely (with additional studies) that we can begin to anticipate specific device dwell time time for at least groups of patients. For example, a diabetic patient having a particular IV drug administered through a short peripheral device sited in the dorsum of the hand may have a different IV outcome to an identical patient with the device sited in the forearm. I feel that we are just at the beginning of our journey of understanding the complex variables that influence peripheral IV longevity. A good starting point when looking at variables and risk factors is the study by Wallis et al (2014) who state “PIVC survival is improved by preferential forearm insertion, selection of appropriate PIVC diameter, and insertion by intravenous teams and other specialists.” The abstract is available here http://www.ivteam.com/intravenous-literature/study-describes-independent-risk-factors-for-peripheral-intravenous-catheter-pivc-failure/

Answers Answered By: ivteam Level Rating10 points

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