References

Alexandrou E., Ray-Barruel G., Carr P. J., Frost S. A., Inwood S., Higgins N., Lin F., Alberto L., Mermel L., Rickard C. M. Use of short peripheral intravenous catheters: characteristics, management, and outcomes worldwide. Journal of Hospital Medicine. 2018; 13:(5) https://doi.org/10.12788/jhm.3039

Allnurses.com. IV left in arm after discharge. 2018. https://allnurses.com/iv-left-arm-discharge-t668708/

Aufricht G., Hoang J., Iglesias J., Latiolais H., Sheffield H., Trejo C., Holder M., Smith S., Garrett J., Columbus C. Analysis of central venous catheter utilization at a quaternary care hospital. Proceedings (Baylor University Medical Center). 2019; 32:(1)1-4 https://doi.org/10.1080/08998280.2018.1542651

Becerra M. B., Shirley D., Safdar N. Prevalence, risk factors, and outcomes of idle intravenous catheters: An integrative review. American Journal of Infection Control. 2016; 44:(10)e167-e172 https://doi.org/10.1016/j.ajic.2016.03.073

Grieving family wants to know how hospital failed to remove cannula. 2019. https://www.theadvocate.com.au/story/6547978/family-wants-answersfrom-mch/

Bourgault A. M., Penoyer D. A., Upvall M. J. It depends. Journal of Infusion Nursing. 2021; 44:(2)103-112 https://doi.org/10.1097/nan.0000000000000418

Canadian Vascular Access and Infusion Therapy Guidelines.: Pappin Communications; 2019

Castro-Sanchez E., Charani E., Drumright L. N., Sevdalis N., Shah N., Holmes A. H. Fragmentation of care threatens patient safety in peripheral vascular catheter management in acute care—a qualitative study. PLOS One. 2014; 9:(1) https://doi.org/10.1371/journal.pone.0086167

Chandramohan S., Navalkele B., Mushtaq A., Krishna A., Kacir J., Chopra T. Impact of a multidisciplinary infection prevention initiative on central line and urinary catheter utilization in a long-term acute care hospital. Open Forum Infectious Diseases. 2018; 5:(7) https://doi.org/10.1093/ofid/ofy156

Chen S., O'Malley M., Chopra V. How common are indwelling devices in hospitalized adults? A contemporary point prevalence study in a tertiary care hospital. American Journal of Infection Control. 2021; 49:(2)194-197 https://doi.org/10.1016/j.ajic.2020.06.205

Chopra V., Govindan S., Kuhn L., Ratz D., Sweis R. F., Melin N., Thompson R., Tolan A., Barron J., Saint S. Do clinicians know which of their patients have central venous catheters?: a multicenter observational study. Annals of Internal Medicine. 2014; 161:(8)562-567 https://doi.org/10.7326/M14-0703

Cooke M., Ullman A. J., Ray-Barruel G., Wallis M., Corley A., Rickard C. M. Not ‘just’ an intravenous line: Consumer perspectives on peripheral intravenous cannulation (PIVC). An international cross-sectional survey of 25 countries. PLOS One. 2018; 13:(2) https://doi.org/10.1371/journal.pone.0193436

Corley A., Ullman A. J., Mihala G., Ray-Barruel G., Alexandrou E., Rickard C. M. Peripheral intravenous catheter dressing and securement practice is associated with site complications and suboptimal dressing integrity: A secondary analysis of 40,637 catheters. International Journal of Nursing Studies. 2019; 100 https://doi.org/10.1016/j.ijnurstu.2019.103409

Corral-Gudino L., Rivas-Lamazares A., Gonzalez-Fernandez A., Rodriguez-Maria M., Aguilera-Sanz C., Tierra-Rodriguez A., Runza-Buznego P., Hernandez-Martin E., Ortega-Gil M., Bahamonde-Carrasco A. Does my patient really need this at admission? Seven opportunities for improving value in patient care during their hospitalization. European Journal of Internal Medicine. 2019; 66:92-98 https://doi.org/10.1016/j.ejim.2019.06.007

Egerton-Warburton D., McAllan F., Ramanan R., Lim Z. J., Nagle D., Dendle C., Stuart R. Human factor-designed multimodal intervention reduces the rate of unused peripheral intravenous cannula insertion. Emergency Medicine Australasia. 2019; 31:(3)372-377 https://doi.org/10.1111/1742-6723.13165

Gazarin M., Ingram-Crooks J., Hafizi F., Hall L., Weekes K., Casselman C., Burnett S., Lennard M., Pinches A., Tse D. Improving urinary catheterisation practices in a rural hospital in Ontario. BMJ Open Quality. 2020; 9:(1) https://doi.org/10.1136/bmjoq-2019-000703

IV catheter left in woman's arm. 2021. https://winnipeg.ctvnews.ca/video?clipId=2291721

Giles M., Graham L., Ball J., King J., Watts W., Harris A., Oldmeadow C., Ling R., Paul M., O'Brien A., Parker V., Wiggers J., Foureur M. Implementation of a multifaceted nurse-led intervention to reduce indwelling urinary catheter use in four Australian hospitals: A pre-and postintervention study. Journal of Clinical Nursing. 2020; 29:(5-6)872-886 https://doi.org/10.1111/jocn.15142

Goossens G. A. Flushing and locking of venous catheters: Available evidence and evidence deficit. Nursing and Research Practice, 2015. 2015; https://doi.org/10.1155/2015/985686

Gorski L., Hadaway L., Hagle M., McGoldrick M., Orr M., Doellman D. Infusion therapy standards of practice. Journal of Infusion Nursing. 2021; 44

Gould C. V., Umscheid C. A., Agarwal R. K., Kuntz G., Pegues D. A. Guideline for prevention of catheter-associated urinary tract infections 2009. Infection Control & Hospital Epidemiology. 2010; 31:(4)319-326 https://doi.org/10.1086/651091

Kaminski M. A., Episcopia B., Malik S., Fornek M., Landman D., Xavier G., Quale J. Trends in central-lineassociated bloodstream infections and catheter-associated urinary tract infections in a large acute-care hospital system in New York City, 2016-2019. Infection Control & Hospital Epidemiology. 2021; 42:(7)842-846 https://doi.org/10.1017/ice.2020.1293

Kara A., Johnson C. S., Murray M., Dillon J., Hui S. L. Can the identification of an idle line facilitate its removal? A comparison between a proposed guideline and clinical practice. Journal of Hospital Medicine. 2016; 11:(7)489-493 https://doi.org/10.1002/jhm.2573

Kleinman Sween, J., Lowrie A., Kirmse J. M., Laughlin R. K., Wodziak B., Sampathkumar P. A quality improvement project to decrease utilization of multilumen peripherally inserted central catheters. Infection Control & Hospital Epidemiology. 2021; 42:(2)222-224 https://doi.org/10.1017/ice.2020.411

Kuriyama A., Fowler K. E., Meddings J., Irie H., Kawakami D., Iwasaki H., Sakuraya M., Katayama K., Tokuda Y., Saint S. Reducing unnecessary urethral catheter use in Japanese intensive care units: A multicenter interventional study. Infection Control & Hospital Epidemiology. 2019; 40:(11)1272-1274 https://doi.org/10.1017/ice.2019.258

Laan B. J., Maaskant J. M., Spijkerman I. J. B., Borgert M. J., Godfried M. H., Pasmooij B. C., Opmeer B. C., Vos M. C., Geerlings S. E. De-implementation strategy to reduce inappropriate use of intravenous and urinary catheters (RICAT): A multicentre, prospective, interrupted time-series and before and after study. The Lancet Infectious Diseases. 2020; 20:(7)864-872 https://doi.org/10.1016/S1473-3099(19)30709-1

Lim S., Gangoli G., Adams E., Hyde R., Broder M. S., Chang E., Reddy S. R., Tarbox M. H., Bentley T., Ovington L., Danker W. Increased clinical and economic burden associated with peripheral intravenous catheter-related complications: analysis of a US hospital discharge database. Inquiry. 2019; 56 https://doi.org/10.1177/0046958019875562

Marsh N., Larsen E. N., Takashima M., Kleidon T., Keogh S., Ullman A. J., Mihala G., Chopra V., Rickard C. M. Peripheral intravenous catheter failure: A secondary analysis of risks from 11,830 catheters. International Journal of Nursing Studies. 2021; 124 https://doi.org/10.1016/j.ijnurstu.2021.104095

Marsh N., Webster J., Larson E., Cooke M., Mihala G., Rickard C. M. Observational study of peripheral intravenous catheter outcomes in adult hospitalized patients: A multivariable analysis of peripheral intravenous catheter failure. Journal of Hospital Medicine. 2018; 13:(2)83-89 https://doi.org/10.12788/jhm.2867

Massey D., Craswell A., Ray-Barruel G., Ullman A., Marsh N., Wallis M., Cooke M. e nursing students' perceptions of the current content and pedagogical approaches used in PIVC education. A qualitative, descriptive study. Nurse Education Today. 2020; 94 https://doi.org/10.1016/j.nedt.2020.104577

McHugh S. M., Corrigan M. A., Dimitrov B. D., Morris-Downes M., Fitzpatrick F., Cowman S., Tierney S., Hill A. D., Humphreys H. Role of patient awareness in prevention of peripheral vascular catheter-related bloodstream infection. Infection Control & Hospital Epidemiology. 2011; 32:(1)95-96 https://doi.org/10.1086/657630

Meddings J., Greene M. T., Ratz D., Ameling J., Fowler K. E., Rolle A. J., Hung L., Collier S., Saint S. Multistate programme to reduce catheter-associated infections in intensive care units with elevated infection rates. BMJ Quality & Safety. 2020; 29:(5)418-429 https://doi.org/10.1136/bmjqs-2019-009330

Meddings J., Rogers M. A., Krein S. L., Fakih M. G., Olmsted R. N., Saint S. Reducing unnecessary urinary catheter use and other strategies to prevent catheter associated urinary tract infection: an integrative review. BMJ Quality & Safety. 2014; 23:(4)277-289 https://doi.org/10.1136/bmjqs-2012-001774

Mena Lora, A. J., Ali M., Krill C., Spencer S., Takhsh E., Bleasdale S. C. Impact of a hospital-wide huddle on device utilisation and infection rates: a community hospital's journey to zero. Journal of Infection Prevention. 2020; 21:(6)228-233 https://doi.org/10.1177/1757177420939239

Mestre G., Berbel C., Tortajada P., Alarcia M., Coca R., Fernandez M. M., Gallemi G., Garcia I., Aguilar M. C., Rodriguez-Bano J., Martinez J. A. Successful multifaceted intervention aimed to reduce short peripheral venous catheter-related adverse events: a quasiexperimental cohort study. American Journal of Infection Control. 2013; 41:(6)520-526 https://doi.org/10.1016/j.ajic.2012.07.014

Mitchell B. G., Northcote M., Cheng A. C., Fasugba O., Russo P. L., Rosebrock H. Reducing urinary catheter use using an electronic reminder system in hospitalized patients: A randomized stepped-wedge trial. Infection Control & Hospital Epidemiology. 2019; 40:(4)427-431 https://doi.org/10.1017/ice.2019.31

Niederhauser A., Zullig S., Marschall J., Schweiger A., John G., Kuster S. P., Schwappach D. L. Change in staff perspectives on indwelling urinary catheter use after implementation of an intervention bundle in seven Swiss acute care hospitals: results of a before/after survey study. BMJ Open. 2019; 9:(10) https://doi.org/10.1136/bmjopen-2018-028740

Nurses Specialized in Wound Ostomy and Continence Canada. Canadian standards of practice for nurses specialized in wound, ostomy and continence. 2021. http://nswoc.ca/wp-content/uploads/2021/01/NSWOCStandards_FINAL_HiRes.pdf

Guidelines for the prevention of intravascular catheter-related infections. 2011. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3106269/pdf/cir257.pdf

Hospital slammed for sending man home with cannula still in his arm. 2019. https://www.derbytelegraph.co.uk/news/leicester-royal-infirmaryburton-cannula-3026157

Park M., Giap T. T. Patient and family engagement as a potential approach for improving patient safety: A systematic review. Journal of Advanced Nursing. 2020; 76:(1)62-80 https://doi.org/10.1111/jan.14227

Patel P. K., Gupta A., Vaughn V. M., Mann J. D., Ameling J. M., Meddings J. Review of strategies to reduce central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) in adult ICUs. Journal of Hospital Medicine. 2018; 13:(2)105-116 https://doi.org/10.12788/jhm.2856

Quinn M., Ameling J. M., Forman J., Krein S. L., Manojlovich M., Fowler K. E., King E. A., Meddings J. Persistent barriers to timely catheter removal identified from clinical observations and interviews. The Joint Committee Journal on Quality and Patient Safety. 2020; 46:(2)99-108 https://doi.org/10.1016/j.jcjq.2019.10.004

Ray-Barruel G., Cooke M., Chopra V., Mitchell M., Rickard C. M. The I-DECIDED clinical decision making tool for peripheral intravenous catheter assessment and safe removal: a clinimetric evaluation. BMJ Open. 2020; 10:(1) https://doi.org/10.1136/bmjopen-2019-035239

Ray-Barruel G., Cooke M., Mitchell M., Chopra V., Rickard C. M. Implementing the I-DECIDED clinical decision-making tool for peripheral intravenous catheter assessment and safe removal: protocol for an interrupted time-series study. BMJ Open. 2018a; 8:(6) https://doi.org/10.1136/bmjopen-2017-021290

Ray-Barruel G., Cooke M., Mitchell M., Chopra V., Rickard C. M. Reduction in ‘Just in Case’ cannula rates with a structured assessment and decision tool: An interrupted time-series study. Infection, Disease & Health. 2018b; 23 https://doi.org/10.1016/j.idh.2018.09.038

Raynak A., Paquet F., Marchionni C., Lok V., Gauthier M., Frati F. Nurses' knowledge on routine care and maintenance of adult vascular access devices: A scoping review. Journal of Clinical Nursing. 2020; 29:(21–22)3905-3921 https://doi.org/10.1111/jocn.15419

The forgotten line. 2012. https://psnet.ahrq.gov/web-mm/forgotten-line

Saint S., Trautner B. W., Fowler K. E., Colozzi J., Ratz D., Lescinskas E., Hollingsworth J. M., Krein S. L. A multicenter study of patient-reported infectious and noninfectious complications associated with indwelling urethral catheters. JAMA Internal Medicine. 2018; 178:(8)1078-1085 https://doi.org/10.1001/jamainternmed.2018.2417

Saint S., Wiese J., Amory J. K., Bernstein M. L., Patel U. D., Zemencuk J. K., Bernstein S. J., Lipsky B. A., Hofer T. P. Are physicians aware of which of their patients have indwelling urinary catheters?. The American Journal of Medicine. 2000; 109:(6)476-480 https://doi.org/10.1016/s0002-9343(00)00531-3

Schreiber P. W., Sax H., Wolfensberger A., Clack L., Kuster S. P. The preventable proportion of healthcare-associated infections 2005-2016: Systematic review and meta-analysis. Infection Control & Hospital Epidemiology. 2018; 39:(11)1277-1295 https://doi.org/10.1017/ice.2018.183

Schweiger A., Kuster S. P., Maag J., Zullig S., Bertschy S., Bortolin E., John G., Sax H., Limacher A., Atkinson A., Schwappach D., Marschall J. Impact of an evidence-based intervention on urinary catheter utilization, associated process indicators, and infectious and non-infectious outcomes. Journal of Hospital Infection. 2020; 106:(2)364-371 https://doi.org/10.1016/j.jhin.2020.07.002

Scott I. A., Elshaug A. G., Fox M. Low value care is a health hazard that calls for patient empowerment. Medical Journal of Australia. 2021; https://doi.org/10.5694/mja2.51168

Seale H., Chughtai A. A., Kaur R., Crowe P., Phillipson L., Novytska Y., Travaglia J. Ask, speak up, and be proactive: Empowering patient infection control to prevent health care acquired infections. American Journal of Infection Control. 2015; 43:(5)447-453 https://doi.org/10.1016/j.ajic.2015.01.007

Septimus E. J., Moody J. Prevention of device-related healthcare-associated infections. F1000Res. 2016; 5 https://doi.org/10.12688/f1000research.7493.1

Shadle H. N., Sabol V., Smith A., Stafford H., Thompson J. A., Bowers M. A bundle-based approach to prevent catheter-associated urinary tract infections in the intensive care unit. Critical Care Nurse. 2021; 41:(2)62-71 https://doi.org/10.4037/ccn2021934

Shah H., Bosch W., Thompson K. M., Hellinger W. C. Intravascular catheter-related bloodstream infection. Neurohospitalist. 2013; 3:(3)144-151 https://doi.org/10.1177/1941874413476043

Shum A., Wong K. S., Sankaran K., Goh M. L. Securement of the indwelling urinary catheter for adult patients: a best practice implementation. International Journal of Evidence-Based Healthcare. 2017; 15:(1)3-12 https://doi.org/10.1097/XEB.0000000000000084

Snyder R. L., White K. A., Glowicz J. B., Novosad S. A., Soda E. A., Hsu S., Kuhar D. T., Cochran R. L. Gaps in infection prevention practices for catheter-associated urinary tract infections and central line-associated bloodstream infections as identified by the Targeted Assessment for Prevention Strategy. American Journal of Infection Control. 2021; 49:(7)874-878 https://doi.org/10.1016/j.ajic.2021.01.014

Takashima M., Schults J., Mihala G., Corley A., Ullman A. Complication and failures of central vascular access device in adult critical care settings. Critical Care Medicine. 2018; 46:(12)1998-2009 https://doi.org/10.1097/CCM.0000000000003370

Tarrago R., Nowak J. E., Leonard C. S., Payne N. R. Reductions in invasive device use and care costs after institution of a daily safety checklist in a pediatric critical care unit. The Joint Committee Journal on Quality and Patient Safety. 2014; 40:(6)270-278 https://doi.org/10.1016/s1553-7250(14)40036-9

Trautner B. W., Saint S., Fowler K. E., Van J., Rosen T., Colozzi J., Chopra V., Lescinskas E., Krein S. L. What do patients say about their experience with urinary catheters and peripherally inserted central catheters?. American Journal of Infection Control. 2019; 47:(9)1130-1134 https://doi.org/10.1016/j.ajic.2019.05.031

Vandenhouten C. L., Owens A. K., Hunter M. R., Raynak A. Peripheral intravenous education in North American nursing schools: A call to action. Journal of Nursing Education. 2020; 59:(9)493-500 https://doi.org/10.3928/01484834-20200817-03

Wald-Dickler N., Holtom P. D., Phillips M. C., Centor R. M., Lee R. A., Baden R., Spellberg B. Oral is the new IV – challenging decades of blood and bone infection dogma: A systematic review. American Journal of Medicine. 2021; https://doi.org/10.1016/j.amjmed.2021.10.007

Walz J. M., Ellison R. T., Mack D. A., Flaherty H. M., McIlwaine J. K., Whyte K. G., Landry K. E., Baker S. P., Heard S. O. The bundle ‘plus’: The effect of a multidisciplinary team approach to eradicate central line-associated bloodstream infections. Anesthesia & Analgesia. 2015; 120:(4)868-876 https://doi.org/10.1213/ANE.0b013e3182a8b01b

World Health Organization. Patient safety. 2019. https://www.who.int/news-room/facts-in-pictures/detail/patient-safety

Xiong Z., Chen H. Interventions to reduce unnecessary central venous catheter use to prevent central line-associated bloodstream infections in adults: A systematic review. Infection Control & Hospital Epidemiology. 2018; 39:(12)1442-1448 https://doi.org/10.1017/ice.2018.250

Yagnik L., Graves A., Thong K. Plastic in patient study: Prospective audit of adherence to peripheral intravenous cannula monitoring and documentation guidelines, with the aim of reducing future rates of intravenous cannula related complications. American Journal of Infection Control. 2017; 45:(1)34-38 https://doi.org/10.1016/j.ajic.2016.09.008

Yu S., Marshall A. P., Li J., Lin F. Interventions and strategies to prevent catheter-associated urinary tract infections with short-term indwelling urinary catheters in hospitalized patients: An integrative review. International Journal of Nursing Practice. 2020; 26:(3) https://doi.org/10.1111/ijn.12834

Zingg W., Pittet D. Peripheral venous catheters: an under-evaluated problem. International Journal of Antimicrobial Agents. 2009; 34:S38-42 https://doi.org/10.1016/S0924-8579(09)70565-5

Vascular Access/IV

I-DECIDED®—a decision tool for assessment and management of invasive devices in the hospital setting

21 April 2022

Canadian Vascular Access Association

02 April 2022

Volume 31 · Issue 8

ISSN (print): 0966-0461

ISSN (online): 2052-2819

Abstract

Indwelling medical devices, including vascular access and urinary catheters, pose a risk for infection, and therefore daily assessment and consideration of their continued need is a patient safety priority. The I-DECIDED® device assessment and decision tool is an evidence-based checklist, designed to improve the assessment, care and timely removal of invasive devices in acute hospitalized patients. This paper explains each step of the tool, with rationale for inclusion.

Approximately 420 million patients annually are admitted to hospital (World Health Organization, 2019). A US prevalence study identified 91% of hospitalized adults had at least one invasive device, such as central venous access device (CVAD), peripheral intravenous catheter (PIVC), or indwelling urethral catheter (IUC), with many patients requiring multiple devices concurrently (Chenetal, 2021). Despite the high prevalence of devices, this practice is not risk-free. Invasive devices breach the normal protective mechanisms of the body (eg skin, mucous membranes) and pose a risk for introduction of microorganisms, potentially leading to local or bloodstream infection (Schreiber et al, 2018). Furthermore, many devices are left in when no longer medically indicated, placing patients at risk of healthcare-associated complications and infection, increased morbidity and mortality, extended hospital stay and financial burden for the healthcare system, and personal and economic consequences for the patient (Becerra et al, 2016; Meddings et al, 2014; Patel et al, 2018; Xiong and Chen, 2018).

Register now to continue reading

Thank you for visiting British Journal of Nursing and reading some of our peer-reviewed resources for nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

Limited access to clinical or professional articles
Unlimited access to the latest news, blogs and video content

Or continue by

Signing in with your registered email address

Intravenous catheter

Urethral catheter

Guidelines

Education

Infection prevention

Patient safety