What is the Recommended Dressing for a PIVC?
Current guidelines recommend that peripheral intravenous catheters (PIVC) dressings are:
Sterile - to prevent infection.
Occlusive - to prevent infection from external pathogens.
Semi-permeable - to prevent sweating (diaphoresis) and associated complications.
Transparent - to allow frequent monitoring of the PIVC insertion.
The use of barrier solutions is recommended to reduce the risk of skin injury.
Avoid rolled bandages, sutures and non-sterile tapes for additional securement as they are proven to be ineffective and associated with increased risk of infection. Tissue adhesive is a proven method of additional security on PIVCs.
Alternative Dressings
In case of suspected allergy, consider allergy to skin preparation in addition to allergy to dressings. Consider spot testing different manufacturers’ dressings and skin preparations to identify the allergen.
Non-occlusive sterile gauze dressings are an alternative to transparent dressings but require more frequent changes (every 2 days).
Dressing Changes
Just like central venous access devices, PIVCs require routine dressing changes.
Change occlusive dressings at least every 7 days, or immediately if:
Dressing integrity is disrupted (lifted, soiled, or moist).
Skin integrity is compromised under the dressing.
Change non-occlusive sterile gauze dressings every 2 days or earlier if dressing integrity is disrupted.
Follow the manufacturer’s instructions and assess skin integrity with each dressing change.
Steps to Applying
Perform patient assessment for optimal dressing, securement and skin preparation.
Remove excess hair using single-patient-use scissors or disposable-head surgical clippers.
Perform skin antisepsis at the site using 2% chlorhexidine gluconate in 70% alcohol, allowing it to air dry as per manufacturer’s instructions.
Use tissue adhesive as an adjunct to the primary dressing for added security, if required.
Using aseptic technique, gently apply the dressing without stretching to prevent skin injury.
Label the dressing with the date according to local procedures.
Protect the PIVC during showering or bathing by covering the dressing site with a clear plastic wrap.
References
Australian Commission on Safety and Quality in Health Care. (2021). Management of Peripheral Intravenous Catheters Clinical Care Standard.
Nickel, B., Gorski, L., Kleidon, T., Kyes, A., DeVries, M., Keogh, S., Meyer, B., Sarver, M. J., Crickman, R., & Ong, J. (2024). Infusion therapy standards of practice. Journal of Infusion Nursing, 47(1S), S1-S285.
Pittiruti, M., Van Boxtel, T., Scoppettuolo, G., Carr, P., Konstantinou, E., Ortiz Miluy, G., Lamperti, M., Goossens, G. A., Simcock, L., Dupont, C., Inwood, S., Bertoglio, S., Nicholson, J., Pinelli, F., & Pepe, G. (2023). European recommendations on the proper indication and use of peripheral venous access devices (the ERPIUP consensus): A WoCoVA project. The Journal of Vascular Access, 24(1), 165-182. https://doi.org/10.1177/11297298211023274
World Health Organization. (2024). Guidelines for the prevention of bloodstream infections and other infections associated with the use of intravascular catheters. Part I: peripheral catheters. World Health Organization.
