What is the recommended frequency for changing a peripheral IV catheter?

A Cochrane systematic review (Webster et al, 2015) found no difference in bloodstream infection and phlebitis rates between PIVCs that are changed at 72-96 hours or changed when clinically indicated. Furthermore, switching to clinically indicated replacement can save patients' veins and reduce healthcare costs. For this reason, many international IV guidelines are now updating their policies.

Clinically indicated means the PIVC is still needed and still working, with no evidence of complications.

The take home message?

All IV catheters should be assessed regularly and removed promptly when they are no longer needed, are causing pain, or are not working properly. An IV catheter that is still in use and functioning well can remain in place until no longer required. Don't insert a PIVC unless you are fairly certain the patient is likely to need one. And never leave an IV in place just in case it might be needed in a day or so.

 

References:

Webster J, Osborne S, Rickard CM, New K. Clinically-indicated replacement versus routine replacement of peripheral venous catheters. Cochrane Database of Systematic Reviews 2015, Issue 8. Art. No.: CD007798. DOI: 10.1002/14651858.CD007798.pub4.
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007798.pub4/full

Rickard CM, Webster J, Wallis MC, Marsh N, McGrail MR, French V, Foster L, Gallagher P, Gowardman JR, Zhang L, McClymont A, Whitby M.. Routine versus clinically indicated replacement of peripheral intravenous catheters: a randomised controlled equivalence trial. Lancet. 2012;380(9847):1066-74. https://www.ncbi.nlm.nih.gov/pubmed/22998716

Tuffaha H, Rickard CM, Webster J, Marsh N, Gordon L, Wallis MC, Scuffham PA. Cost-effectiveness analysis of clinically indicated versus routine replacement of peripheral intravenous catheters. Appl Health Econ Heath Policy. 2014;12(1):51-8. https://www.ncbi.nlm.nih.gov/pubmed/24408785

Loveday HP, Wilson JA, Prieto J, Wilcox MH. epic3: revised recommendation for intravenous catheter and catheter site care. Journal of Hospital Infection. 2016;92(4):346-8. http://dx.doi.org/10.1016/j.jhin.2015.11.011

Royal College of Nursing. Standards for infusion therapy. London, UK: Royal College of Nursing; 2016. https://www.rcn.org.uk/professional-development/publications/pub-005704

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