Things We Do for No Reason™: Routinely maintaining intravenous access in hospitalized patients

Peripheral intravenous catheters (PIVCs) are widely used in hospitalized patients and are often maintained even after the need for intravenous therapy has resolved. This article challenges the routine practice of maintaining idle PIVCs in clinically stable patients. While PIVCs offer convenient access for emergent treatment, they are associated with risks-including local infections, phlebitis, and vascular damage-as well as significant patient discomfort. Notably, although PIVCs carry a lower individual risk of bloodstream infection compared with central venous catheters, their widespread use makes them responsible for up to one-third of Staphylococcus aureus catheter-related bacteremia. Furthermore, idle PIVCs often fail before use, and intraosseous access provides an effective alternative in true emergencies. As many intravenous medications can be safely and effectively administered orally, the continued use of PIVCs in stable patients may offer little benefit while introducing avoidable harms and costs. Clinicians should regularly reassess the need for intravenous access and remove idle PIVCs when appropriate to promote patient safety and comfort.