Global evaluation of healthcare workers' knowledge and practices in IV catheter management: cross-sectional survey

The Global Committee of the World Congress on Vascular Access (WoCoVA) launched a cross-sectional descriptive survey between February and April 2024 to evaluate healthcare workers' knowledge and routine practices regarding intravenous (IV) catheter management on a global scale. The primary objective was to capture real-world, day-to-day practices rather than institutional or national guideline compliance. The aim was to provide an updated global perspective and identify areas for targeted education and guideline dissemination by WoCoVA.

An anonymous online questionnaire was distributed to health professionals registered in the WoCoVA mailing list. The questionnaire comprised sections on catheter dressing and infection prevention (30 questions), catheter patency (22 questions), and locking practices (8 questions).

251 responses were analysed, from 44 countries. IV team nurses, anaesthetists, intensive care unit professionals and specialists in oncology were the more represented specialties. The skin is disinfected by scrubbing in 65% of responses, with considerable variability in the procedure; 98% use a transparent semi-permeable dressing. To disinfect needle-free connectors alcohol 70% (53%) or chlorhexidine 2% in alcohol 70% (50%) are the first choice; scrubbing is used by 73% of respondents. For management of catheter patency, 43% apply a high force on the plunger to flush. When they use a 10 ml syringe, 79% flush 10 short volumes of 1 ml saline interrupted by brief pauses. Various solutions are used for catheter locking.

Clarification is needed regarding definitions of loss of patency, flushing, rinsing, and locking. Further analysis is required to correlate locking practices with frequency of use. Despite a general alignment with evidence-based standards in certain areas, variation persists in practices such as disinfection methods, flushing techniques, and locking strategies. There is a pressing need for evidence-based recommendations approved by an international committee, and reflection on the best way to spread best practices.