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Updated: May 18, 2026
09:57
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 versus clinically indicated replacement of peripheral intravenous catheters: a randomised controlled
Claire M Rickard1, Joan Webster, Marianne C Wallis
1Research Centre for Clinical and Community Practice Innovation, Griffith Health Institute, Griffith University, Nathan, QLD, Australia. c.rickard@griffith.edu.au
Lancet (London, England)
|September 25, 2012
Summary
Clinically indicated replacement of peripheral intravenous catheters is as effective as routine replacement. This approach reduces patient discomfort, healthcare costs, and staff workload by avoiding unnecessary procedures.
Area of Science:
- Medical Interventions
- Clinical Practice Guidelines
- Patient Safety
Background:
- Millions of peripheral intravenous catheters (PIVCs) are used annually, with routine replacement every 72-96 hours recommended for adults.
- This standard practice increases healthcare costs, staff workload, and necessitates repeated invasive procedures for patients.
- The clinical effectiveness of routine PIVC replacement is not well-established.
Purpose of the Study:
- To test the hypothesis that clinically indicated PIVC replacement is equivalent in benefit to routine replacement.
- To evaluate the impact of PIVC replacement strategies on patient outcomes and healthcare resource utilization.
Main Methods:
- A multicentre, randomised, non-blinded equivalence trial involving adults (≥18 years) with PIVCs expected to be in use for over 4 days.
- Participants were randomly assigned (1:1) to either clinically indicated or routine (every third day) PIVC replacement.
- The primary outcome was phlebitis, with an equivalence margin set at 3%.
Main Results:
- Phlebitis occurred in 7% of patients in both the clinically indicated (114/1593) and routine replacement (114/1690) groups.
- The absolute risk difference for phlebitis was 0.41%, falling within the 3% equivalence margin.
- Mean catheter dwell time was longer in the clinically indicated group (99 hours) compared to the routine group (70 hours).
Conclusions:
- Clinically indicated replacement of peripheral intravenous catheters is an effective alternative to routine replacement.
- Adopting a clinically indicated replacement policy can significantly reduce catheter insertions, patient discomfort, and associated costs.
- Continued close monitoring and prompt removal of catheters upon complication are essential.
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