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Updated: Jul 3, 2026
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A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
Published on: July 13, 2019
Routine care of peripheral intravenous catheters versus clinically indicated replacement: randomised controlled
Joan Webster1, Samantha Clarke, Dana Paterson
1Centre for Clinical Nursing, Royal Brisbane and Women's Hospital, Herston, Qld 4029, Australia. joan_webster@health.qld.gov.au
BMJ (Clinical Research Ed.)
|July 11, 2008
Summary
Replacing peripheral intravenous catheters only when needed is as effective as routine replacement. This approach does not increase catheter failure rates like phlebitis or infiltration and may reduce costs.
Area of Science:
- Medical Interventions
- Infection Control
- Clinical Practice Guidelines
Background:
- Peripheral intravenous catheters are commonly used in healthcare settings.
- Catheter-related complications, such as phlebitis and infiltration, can lead to treatment delays and increased costs.
- Current guidelines vary regarding the optimal timing for peripheral intravenous catheter replacement.
Purpose of the Study:
- To compare the clinical outcomes and costs associated with routine peripheral intravenous catheter replacement versus replacement only when clinically indicated.
- To evaluate the incidence of catheter failure, defined as phlebitis or infiltration, in both intervention and control groups.
Main Methods:
- A randomised controlled trial was conducted with 755 medical and surgical patients at a tertiary hospital in Australia.
- Patients were allocated to either routine catheter replacement or replacement based on clinical indication.
- Catheter failure was assessed using a composite measure of phlebitis or infiltration.
Main Results:
- No significant difference in catheter failure rates (phlebitis or infiltration) was observed between the groups (33% in the control group vs. 38% in the intervention group).
- Analysis per 1000 device days also showed no significant difference in failure rates between the groups.
- Infusion-related costs were lower in the group where catheters were replaced only when clinically indicated.
Conclusions:
- Replacing peripheral intravenous catheters only when clinically indicated is a safe and effective strategy, with no increase in failure rates.
- This approach may lead to cost savings compared to routine replacement.
- Further research using phlebitis as a primary outcome is recommended for larger trials.
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