Peripheral Intravenous Catheter Complications: A Comparative Analysis of 6 Reference Documents

Abstract

OBJECTIVE: The objective of this study was to analyze current evidence-based pan-European standards of good clinical practice in the use of peripheral intravenous catheters (PIVCs) to determine if they meet clinicians' needs for unambiguous, standardized guidance for the prevention and management of PIVC-associated complications.

METHODS: Reference documents meeting agreed inclusion criteria were identified and analyzed. Documents were systematically searched for terms (selected based on expertise of the authors and supported by scientific literature) most likely to be associated with the prevention/management of complications associated with the use of PIVCs. A matrix was constructed to visualize the degree of consensus across guidelines regarding prevention and management terminology. Recommendations for optimizing clarity and standardization across Europe were proposed.

RESULTS: Few European reference documents included PIVCs within their scope, and few were subject to a quality review. Adherence to the established GRADE framework of rating supporting evidence was missing from all reference documents. There was ambiguous terminology across documents and many instances of omission of terms rated important by the authors for the prevention and management of complications.

CONCLUSION: An English-language European guideline for the prevention of complications associated with PIVCs is needed, featuring consensus terminology and a standardized, systematic, and transparent method for grading evidence.