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Prevention of peripheral intravenous catheter-related bloodstream infections: the need for a new focus

Claire M Rickard, Joan Webster and E Geoffrey Playford
Med J Aust 2013; 198 (10): . || doi: 10.5694/mja13.10428
Published online: 3 June 2013

Careful insertion and maintenance technique on every occasion is important — not routine replacement

Intravascular access device-related bloodstream infections, including Staphylococcus aureus bacteraemias (SABs), cause substantial clinical harm and waste scarce health care resources. And yet, many, if not most, are preventable. We are belatedly realising that to eliminate these complications we must conduct research, implement evidence-based interventions and reduce the clinical practice variation that leads to their occurrence. Public reporting and the financial disincentives associated with apparent poor performance are also pulling us along this path. In this issue of the Journal, Stuart and colleagues provide yet another wake-up call by describing a case series of 137 peripheral intravenous catheter (PIVC)-associated SABs.1 They highlight some important failings in our processes for managing PIVCs that allow devastating complications to occur and which require our urgent attention.


  • 1 NHMRC Centre for Research Excellence in Nursing Interventions for Hospitalised Patients, Griffith Health Institute, Griffith University, Brisbane, QLD.
  • 2 Research and Development Unit, Centre for Clinical Nursing, Royal Brisbane and Women’s Hospital, Brisbane, QLD.
  • 3 School of Nursing and Midwifery, Griffith University, Brisbane, QLD.
  • 4 Princess Alexandra Hospital, Metro South Health, Brisbane, QLD.
  • 5 University of Queensland, Brisbane, QLD.


Correspondence: c.rickard@griffith.edu.au

Competing interests:

No relevant disclosures.

  • 1. Stuart RL, Cameron DRM, Scott C, et al. Peripheral intravenous catheter-associated Staphylococcus aureus bacteraemia: more than 5 years of prospective data from two tertiary health services. Med J Aust 2013; 198: 551-553.
  • 2. Mermel LA, Allon M, Bouza E, et al. Clinical practice guidelines for the diagnosis and management of intravascular catheter-related infection: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis 2009; 49: 1-45.
  • 3. Trinh TT, Chan PA, Edwards O, et al. Peripheral venous catheter-related Staphylococcus aureus bacteremia. Infect Control Hosp Epidemiol 2011; 32: 579-583.
  • 4. Rickard CM, Webster J, Wallis MC, et al. Routine versus clinically indicated replacement of peripheral intravenous catheters: a randomised controlled equivalence trial. Lancet 2012; 380: 1066-1074.
  • 5. Timsit J, Schwebel C, Bouadma L, et al. Chlorhexidine-impregnated sponges and less frequent dressing changes for prevention of catheter related sepsis in critically ill adults: a randomized controlled trial. JAMA 2009; 301: 1231-1241.
  • 6. Pronovost P, Needham D, Berenholtz S, et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med 2006; 355: 2725-2733.
  • 7. Collignon PJ, Dreimanis DE, Beckingham WD, et al. Intravascular catheter bloodstream infections: an effective and sustained hospital-wide prevention program over 8 years. Med J Aust 2007; 187: 551-554. <MJA full text>
  • 8. O’Grady NP, Alexander M, Burns LA, et al. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis 2011; 52: e162-e193.
  • 9. Maki DG, Kluger DM, Crnich CJ. The risk of bloodstream infection in adults with different intravascular devices: a systematic review of 200 published prospective studies. Mayo Clin Proc 2006; 81: 1159-1171.
  • 10. Palese A, Cassone A, Kulla A, et al. Factors influencing nurses’ decision-making process on leaving in the peripheral intravascular catheter after 96 hours: a longitudinal study. J Infus Nurs 2011; 34: 319-326.
  • 11. Webster J, Osborne S, Rickard C, Hall J. Clinically-indicated replacement versus routine replacement of peripheral venous catheters. Cochrane Database Syst Rev 2010; (3): CD007798.

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