TDNet Discover

Background: Standard of care in the hospital setting recommends each patient have an Intravenous line (IV) while they are admitted. The IV line can be used to run fluid for hydration, administer medication, or just be there for direct access to a patient’s bloodstream in emergency situations. While IV lines are extremely common in all hospital settings, there is not a standard of care practiced throughout these hospitals as to the replacement timing of IV catheters. Objective: To determine if clinically indicated replacement or scheduled replacement of IV lines in the hospital setting is more cost effective and/or more beneficial to the patient. Methods: Four databases were utilized to search for studies relating to the research question from October 2018 to February 2019 for an evidence-based medicine literature review to be employed. Search terms and phrases included “clinically‐indicated replacement versus routine replacement of peripheral venous catheters”, “clinically indicated replacement vs. routine replacement of peripheral intravenous catheters in adults”, and “meta-analysis peripheral IVs routinely changed & hospital policy & cost & infection & free text & humans”. The search was limited to the last 10 years, humans, adults, English, free full text, and peer reviewed. All search results were reviewed against the set inclusion criteria and appraised independently for validity by three researchers. Data extraction and quantitative analysis was performed for final selected articles. Results: The evidence-based medicine study design resulted in three articles, one systematic review and two randomized control trials. The articles results found that clinically indicated replacement in IV lines is more cost effective, poses no higher risk of phlebitis to the patient, and reduces the time nurses spend on IV care while routine replacement reduced the rate of blockage of catheters. Conclusions: The three studies analyzed concluded the superior method of IV catheter replacement is clinically indicated. Clinically indicated replacement demonstrated that there is no CLINICALLY INDICATED VS. ROUTINE IV REPLACEMENT v significant difference in rates of phlebitis in clinically indicated replacement versus scheduled replacement of IV lines and overall it was more cost effective. This finding concluded that clinically indicated replacement is no higher of a risk toward patients.