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A new clinical best practice standard that changes the approach to peripheral intravenous catheters (PIVC) has been released by the Australian Commission on Safety and Quality in Health Care.


The national standard, The Management of Peripheral Intravenous Catheters Clinical Care, released today, provides guidance on best practice care and skilful use of PIVC’s which includes prompting health workers to consider whether a cannula is really necessary before insertion.

In addition the standard outlines how to insert, maintain and remove PIVCs safely and effectively describes the care that patients should expect to receive if they have a PIVC inserted during a hospital stay.

According to the Commission the standard was necessary given that 7.7 million Australians have a PIVC inserted each year, yet up to 40% of all first-time attempts to insert a PIVC in adults failed. Consequently many patients faced the prospect of undergoing multiple painful attempts before a PIVC is successfully inserted.

Commission Clinical Director, Associate Professor Amanda Walker said the new standard for PIVC would help to improve the techniques used by healthcare professionals and in turn, reduce the risk for patients who may experience issues with insertion or complications afterwards.

“It aims to ensure the best chance of cannulas being inserted correctly the first time, and once they are in, for them to be well maintained, to avoid blockages, infections and other problems such as leakage into the tissue or inflammation.

“An intravenous cannula insertion is an experience that almost everyone who goes to hospital will have. Yet there is a high failure rate of 40% for first-time insertions, and also a high rate of problems, with up to 69% of cannulas needing to be removed due to complications. So let’s embrace this opportunity with the new standard to consider how we can all do it better.”

Nurse and vascular access expert Dr Evan Alexandrou, who is a senior lecturer at Western Sydney University and Clinical Nurse Consultant at Liverpool Hospital in NSW said the new PIVC standard offered the chance to review the procedure in hospitals across the country.

“Peripheral intravenous catheter insertion is one of the most practiced clinical procedures in hospitals, yet it carries the greatest risk of failure of any medical device.”

“Each day, thousands of PIVCs fail in Australian hospitals, and we continue to accept this unacceptable rate of failure. This standard is a way of re-setting our approach. We need to reduce the burden of multiple cannulation attempts on our patients and to achieve this, a standardised approach to promote first insertion success is necessary,” he said.

“Our patients deserve to receive the right device, by the right trained personnel at the right time to minimise delays with treatment and reduce post insertion failure. It’s time to stop accepting the unacceptable.”

The new standard is now available online