Implementation of an Infection Prevention Care Bundle for Peripheral Intravenous Catheters (PIVCs): A Quality Improvement Study to Enhance PIVC Quality and Reduce Complications

实施外周静脉导管(PIVC)感染预防护理包:一项旨在提高PIVC质量并减少并发症的质量改进研究

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Abstract

Background/Objectives: Peripheral intravenous catheters are commonly employed to administer intravenous therapy to hospitalized patients. However, their use can result in complications, with phlebitis occurring in approximately 11% of cases and bloodstream infections in about 0.18%. This study aimed to enhance PIVC management in a local hospital by implementing a comprehensive care bundle to mitigate these complications. Methods: This quality improvement study involved the collection of data from 1330 PIVCs in adult patients, both prior to and following the implementation of the intervention. Data collection occurred between June 2022 and November 2023, employing the validated Peripheral Intravenous Catheter-Mini Questionnaire (PIVC-miniQ). This instrument comprises 16 observation points that assess phlebitis-related signs and symptoms, the integrity of PIVC dressings and IV connections, and the adequacy of documentation. Results: The prevalence of phlebitis decreased from 15.1% at baseline to 9.4% post-intervention (p = 0.018). Significant predictors of phlebitis included the intervention, ward, gender, and PIVC gauge. Improvements were also noted in PIVC dressing and IV connection practices, as well as documentation standards (p < 0.001). Closed integrated PIVCs outperformed ported PIVCs in the PIVC-miniQ scores after the intervention (p < 0.001). A statistically significant difference was observed in the mean PIVC-miniQ sum score post-intervention compared to baseline (p < 0.001). Conclusions: This study indicates that implementing a care bundle can enhance the quality of PIVCs and reduce the prevalence of phlebitis. Further high-quality research is needed to identify the most effective care bundles for preventing PIVC-related complications.

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