I-DECIDED device assessment and decision tool
Up to 70% of acute care hospital patients need a peripheral intravenous catheter (PIVC) for fluids or medicines during admission. However, up to 69% of PIVCs have painful complications or stop working before treatment is finished, requiring the insertion of a new device.1 There are numerous reasons for PIVC failure, some of which may be preventable with appropriate intervention. Improved assessment could help prevention and early detection of complications, but no comprehensive and validated IV assessment tool exists.2
I-DECIDED® is the first comprehensive, evidence-based, valid and reliable vascular access device assessment and decision tool.3,4 This simple checklist promotes comprehensive IV assessment and management, and prompts timely removal of IV devices. The tool has been tested in English in 3 Australian hospitals.5
I-DECIDED® is a summary of evidence-based guidelines for intravascular device care, we encourage its widespread use. You are authorised to I-DECIDED® in your institution.
Please note: I-DECIDED® is trademarked, therefore the mnemonic I-DECIDED cannot be changed.
The tool has been translated into numerous languages. Click on the links below:
For more information, please contact Dr Gillian Ray-Barruel firstname.lastname@example.org
Chart for determining catheter size/length versus appropriate vein diameter and depth from ultrasound assessment Peripheral vascular access devices
The Michigan Appropriateness Guide for Intravenous Catheters (miniMAGIC):
Here is a quick video (Presented by A/Professor Amanda Ullman) explaining the importance of selecting the correct catheter for the job, and how miniMAGIC can assist this process, as well as a link .
Nursing Care of Critically Ill Patients with a Central Venous Catheter:
In this time of COVID-19, many nurses are upskilling to take care of critically ill patients. AVATAR recently collaborated with Continulus to create the following lecture:
Practice Guidelines for Central Venous Access 2020: An Updated Report by the American Society of Anesthesiologists Task Force on Central Venous Access
Dr Evan Alexandrou and his team at Liverpool Hospital recently developed a mini documentary on the use of ultrasound guidance for pathology specimen collection.
The DIVA blood collection service was developed to reduce multiple attempts by pathology staff to access vessels for blood collect.
Patients from the Liver Clinic at Liverpool Hospital are a vulnerable group who have very poor access, may have a history of injecting drug use and are a high risk for loss to follow and treatment.
The DIVA blood collection service has had an unexpected benefit - it has improved patient engagement and removed a significant barrier (multiple painful attempts) to treatment in this high risk group.
A qualitative study is almost complete on the experiences of these patients using the DIVA blood collection service and this video will be an adjunct to the publication
AVATAR State of the Art in Vascular Access Management Seminar
On March 6, 2017 around 100 dedicated clinicians attended the inaugural AVATAR State of the Art in Vascular Access Management seminar, held at Rydges Parramatta. A key aim of the seminar was to present both the evidence and the art of vascular access care in relation to peripheral intravenous catheters (PIVCs); central venous access devices (CVADs) and paediatric vascular access. Attendees were a mixed bunch with vascular access clinicians being the largest group (32%), followed by critical care (18%), inpatient services (11%), cancer services (10%) and infection prevention (9%), with the balance made up of several other speciality groups.
The videos from this seminar are now available:
Video 2: Dr Evan Alexandrou and Prof Claire Rickard outline the State of the Art in relation to peripheral intravascular catheters (PIVCs) with Evan detailing "Right patient, right catheter" principles and Claire presenting the issues and evidence around post-insertion care.
AVATAR educational video on PIVC insertion, maintenance and removal
Peripheral intravenous catheters (PIVCs) are the most commonly used vascular access device in health care with around 65% of hospitalized patients receiving PIVC therapy during their stay. The insertion of a PIVC is the most commonly performed invasive procedure in hospitalized patients. However, failure rates of PIVCs are high at around 40% before the completion of treatment this impacts significantly on patients, staff and the healthcare system. Failure can be a consequence of occlusion, dislodgement, infiltration/extravasation, phlebitis, or local/systemic infection. Prevention of these failures through evidence based practice is important, and as such AVATAR has developed, with an unrestricted grant from Baxter, this educational video on PIVC insertion, maintenance and removal that incorporates best practices based on current evidence. Reducing the complications and failure will provide patients with a better health care experience.
Is your doctor choosing the right IV?
In this article that appeared in The Conversation, October 24, 2015, Dr Vineet Chopra and Dr Scott Flanders from the University of Michigan discuss which IV is right for which patient.
IV Access Device Infection Risks webinar
This 20 minute webinar, produced by the Australian College of Infection Prevention and Control, is presented by Dr Gillian Ray-Barruel from the AVATAR Group.
Clincially indicated site rotation: How do we get there?
This is a presentation from AVA ASM 16 Sept 2015 at an AVAS/AVATAR seminar, given by Marcia Wise, recipient of the AVA 2015 Suzanne LaVere Herbst Award for Excellence in Vascular Assess.
In these videos Dr. Vineet Chopra of the U-M Medical School, VA Ann Arbor Healthcare System and U-M Institute for Healthcare Policy and Innovation describes the newly published Michigan Appropriateness Guideline for Intravenous Catheters, or MAGIC -- a set of criteria for choosing the best and safest IV device for each patient based on research and expert consensus.
Ultrasound-guided PIV placement
The following link provides access to a video in the New England Journal of Medicine on ultrasound-guided peripheral intravenous placement.
Click This Link Here
(REF) Joing S, Strote S, Caroon L, Wall C, Jess K, Roline C et al Videos in clinical medicine. Ultrasound-guided peripheral i.v. placement. N Engl J Med 2012; 366(25):e38
Infection prevention and control
Tasmanian Government Department of Health and Human Services provide a resource in relation to infection prevention and control that includes:
- eLearning infection prevention and control series of short, self-directed educational videos provides basic infection prevention and control topics and principles
- Four short videos demonstrate how to put on and remove PPE safely when using standard and transmission based precautions.
Link: Click Here
How to Assess a Peripheral IV Cannula (Ausmed educational video)
In this 30-minute video produced by Ausmed, Dr Gillian Ray-Barruel, Senior Research Fellow with AVATAR, explains how to assess a PIVC using the I-DECIDED tool and what to do about PIVC complications.
Preventing Central Line-Associated Bloodstream Infections (Ausmed educational video)
In this 20-minute video, produced by Ausmed, Dr Gillian Ray-Barruel, a Senior Research Fellow with AVATAR, explains how to prevent central line-associated bloodstream infections.
The Canadian Institute of Health Research is a valuable resource for information in knowledge translation.
ImprovePICC is the premier destination for the latest PICC-related research and evidence, and is a valuable resource for PICC-related research and evidence.
A resource for Central line infections, CRBSI and CLABSI can be found at