An Implementation Framework for the Clinically Indicated Removal Policy for Peripheral Intravenous Catheters
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Published on: July 13, 2019
Mari Takashima1, Marie Cooke, Michelle DeVries
1Alliance for Vascular Access Teaching and Research (AVATAR), Menzies Health Institute Queensland, Griffith University, Brisbane, Australia (Mss Takashima, DeVries, and Kleidon, Drs Cooke, Alexandrou, Chopra, and Rickard); Nursing and Midwifery, Griffith University, Brisbane, Australia (Drs Cooke and Rickard); Methodist Hospitals, Gary, Indiana (Ms DeVries); Vascular Assessment and Management Service, Queensland Children's Hospital, Brisbane, Australia (Ms Kleidon); School of Nursing and Midwifery, Western Sydney University, Sydney, New South Wales, Australia (Dr Alexandrou); Department of Intensive Care, Liverpool Hospital, Sydney, New South Wales, Australia (Dr Alexandrou); and Michigan Medicine, University of Michigan Health System, Ann Arbor (Dr Chopra).
Background:
Equivalent clinical outcomes, lower costs, and fewer invasive procedures have resulted in revised recommendations for the removal of peripheral intravenous catheters (PIVCs) from the traditional 72- to 96-hourly removal to removal based upon clinical indication.
Problem:
Uptake of this evidence-based innovation to health systems is often delayed, in part due to the lack of a guiding framework for successful implementation strategies to guide systems to transition to and sustain clinically indicated PIVC removal.
Approach:
We used the Consolidated Framework for Implementation Research (CFIR) to reflect on strategies likely important for the successful implementation of PIVC removal evidence into policy and practice.
Outcomes:
We discuss and provide a critique of salient strategies for successful implementation of clinically indicated PIVC removal with regard to intervention characteristics, the outer and inner settings, characteristics of individuals, and implementation processes.
Conclusions:
Successful implementation of clinically indicated PIVC removal can be achieved through planned and systematic processes within the CFIR framework.
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