A PIVC Bundle That Actually Worked: 38 Australian Hospitals Cut Bloodstream Infections

Study Overview

Peripheral intravenous catheters (PIVCs) are used in most hospitalised patients, but complications and infections can be preventable when care is consistent. This quality improvement initiative rolled out an evidence-based PIVC bundle across 38 private hospitals in Australia (2022-2023), aligned to the Australian Clinical Care Standard (2021).

The bundle wasn’t just “education”—it was a full system package: a service-wide PIVC policy, redesigned nursing documentation, the I-DECIDED® assessment tool, audit and reporting upgrades, consumer information updates, and the introduction of prefilled saline flush syringes.

Key Findings

- Bloodstream infections decreased
Overall Staphylococcus aureus bloodstream infections (SABSI) dropped by 21%, and intravenous catheter-associated SABSI dropped by 10% after implementation.

- Local PIVC infection fell sharply
Local PIVC infection reduced by 55%.

- Documentation and care-standard compliance improved
Documentation of insertion attempts improved from 32% to 65%, and overall documentation improved from 74% to 83%. Documentation of patient education/consent improved from 47% to 80%.

- Escalation practices improved
Ultrasound use for difficult insertion increased from 21% to 30%.

- Nursing time was saved at scale
Using prefilled flush syringes saved 49 seconds per flush, translating to large workforce time savings when scaled across the hospital network. The analysis also estimated an annual cost saving (noting exact product costing details were restricted).

- Staff were on board
Staff satisfaction with the change was above 90%.

Implications

This is a strong real-world example that system-wide standardisation can reduce infections—especially when the intervention is practical and measurable (policy + forms + auditing + reporting + patient info + workflow tools). The biggest takeaway is that bundles work best when they help clinicians do the right thing every time, not just once during training.

It also highlights a key implementation lesson: success wasn’t only from introducing tools, but from improving governance, documentation expectations, audit visibility, and data accuracy (so teams could track what’s really happening and respond).

Read more:https://www.idhjournal.com.au/article/S2468-0451(25)00215-9/fulltext 

Authors: Nicola Isles; Gillian Ray-Barruel