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An Implementation Framework for the Clinically Indicated Removal Policy for Peripheral Intravenous Catheters
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).
Revised guidelines recommend removing peripheral intravenous catheters (PIVCs) based on clinical need, not a fixed schedule. Implementing this evidence-based practice requires a structured approach for successful adoption and sustained use in healthcare systems.
Area of Science:
- Healthcare innovation adoption
- Evidence-based practice implementation
- Clinical workflow optimization
Background:
- Peripheral intravenous catheters (PIVCs) removal guidelines have shifted from timed (72-96 hours) to indication-based removal.
- This change is driven by equivalent clinical outcomes, reduced costs, and fewer invasive procedures.
Purpose of the Study:
- To address the delayed uptake of evidence-based PIVC removal practices in health systems.
- To provide a framework for the successful implementation and sustainability of clinically indicated PIVC removal.
Main Methods:
- Utilized the Consolidated Framework for Implementation Research (CFIR) to analyze implementation strategies.
- Reflected on strategies crucial for integrating PIVC removal evidence into policy and practice.
Main Results:
- Critiqued key implementation strategies across intervention characteristics, settings (outer and inner), individual factors, and processes.
- Identified critical elements for successful adoption of clinically indicated PIVC removal.
Conclusions:
- Clinically indicated PIVC removal implementation is achievable through systematic processes.
- The CFIR framework provides a roadmap for successful transition and sustained use of this evidence-based practice.
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