Multidimensional outcomes in intravenous access device maintenance: a pilot study

The nursing and pharmacology literature of 1988 to 1992 generally encouraged a change in nursing practice with regard to maintenance of peripheral intravenous access devices in adults. Although recommendations were based on data, methodological limitations in many studies prevented enthusiastic change from heparinized saline to saline alone. The article describes the quality journey of one community hospital toward practice change in this frequently performed patient care procedure. The success of the change is attributed to pilot outcomes work in the regional tertiary medical center, which demonstrated the credibility of the proposed change. Four organizational processes supported the scientifically based quality change: interdisciplinary efforts of the community hospital instituting the change, a test on one nursing unit, positive recognition of staff undergoing practice change, and publication and dissemination of the clinical procedure change.