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Area of Science:

  • Nursing Practice
  • Quality Improvement
  • Healthcare Management

Background:

  • Current hospital policy for peripheral intravenous catheters (PIVCs) required routine replacement.
  • This practice was outdated compared to clinical practice guidelines (CPGs) recommending clinically indicated replacement.

Purpose of the Study:

  • To update the PIVC replacement policy to align with CPGs.
  • To evaluate the impact of implementing clinically indicated PIVC replacement on a medical unit.

Main Methods:

  • A quality improvement initiative using Lean principles was led by a clinical nurse leader (CNL).
  • A small test of change was conducted on a 38-bed medical unit.
  • Quality, safety, and workflow measures were used to assess the impact of the CPG.

Main Results:

  • Routine PIVC replacement decreased from 34% to 3% (P < .001).
  • PIVC dwell time did not correlate with increased phlebitis (P = .41) or catheter-related bloodstream infections.
  • Nurses reported improved workflow (P = .01) and patient care quality (94%).

Conclusions:

  • Clinically indicated PIVC replacement effectively reduces unnecessary insertions and maintains patient safety.
  • The updated guideline improved efficiency and is being adopted hospital-wide.
  • This initiative demonstrates the CNL's role in healthcare transformation.