Nursing Interventions to Minimize the Unnecessary Replacement of Peripheral Intravenous Catheters: A Systematic...

Background: Peripheral intravenous catheters (PIVCs) is widely considered the most common invasive procedure in hospitals, and it is estimated that these devices are used annually up to two billion times worldwide. The main complication of this procedure is the appearance of phlebitis, which can cause pain, edema, tenderness, erythema, or the development of a palpable cord around the cannulated vein. Premature failure of PIVCs increases the cost of health care. Objective: To describe interventions carried out by nursing professionals aimed at increasing the lifespan of PIVCs. Methods: A systematic review following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) was carried out. A bibliographic keyword search was performed on search engines between December 2021 and January 2022. Articles were selected independently by two of the authors. The protocol for this systematic review was properly recorded. Inclusion and exclusion criteria were defined (see "Methods" section). The PEDro scale was used to ensure the quality of the selected studies. Results: Fifty-two articles were screened, with 14 articles ultimately selected. The outcomes were prioritized by the number of articles that mentioned them, divided into primary and secondary outcomes. We found the following as primary outcomes: phlebitis occurrence, PIVC location, occlusion occurrence, PIVC dwell time, bloodstream infection, and infiltration rate. Secondary outcomes were dislodgement occurrence, presence of pain, local venous infection, PIVC colonization, number of PIVCs per patient, and accidental removal. Conclusions: PIVC material or the use of heparin can prevent phlebitis or the occurrence of occlusion. Ultra-long PIVCs show improvements in dwell time. Routine PIVC replacement has fallen into disuse. Implications for Nursing: Knowledge of the different PIVC materials and their lifespan is an area of nursing competence. Some methods increase PIVCs' dwell time. The use of heparin solutions or Vialon catheters may prevent phlebitis occurrence. The use of Vialon catheters or achieving better fixation by adding cyanoacrylate drops under the dressings could reduce occlusion occurrence. Hospital nurses are the main parties responsible for the management of peripheral venous catheters, and their interventions should be aimed at increasing the catheters' dwell time and reducing complications.