In this article, Cliodhna Grady, Clinical Risk Advisor, describes the complications associated with peripheral intravenous cannula (PIVC) management and how health and social care professionals can avoid them.*
The complications associated with PIVC management can have a significant effect on service users’ health and quality of life, and increase the cost of healthcare through the need for prolonged hospital stays and treatment. For example, mismanagement of PIVCs can result in blood stream infections, which may require prolonged courses of intravenous antibiotics. This in turn can drive anti-microbial resistance.
PIVC-related adverse incidents recorded on NIMS, the National Incident Management System, include infiltration, extravasation, phlebitis, haematoma formation, and failure to remove a cannula prior to discharge.
To reduce the risk of adverse effects to service users, health and social care professionals need appropriate education and training in PIVC management to ensure they undertake this role competently.
Risks associated with PIVC
Possible complications of PIVC management are:
- Infection - Bacteria may enter through the insertion site, resulting in local infection or blood stream infection
- Extravasation (infiltration of the injected fluid into the surrounding tissue) - particularly during administration of contrast media and iron infusions, which can cause significant skin staining
- Phlebitis (vein irritation, more common in older service users) - due to the presence of the catheter, irritation from fluids injected or infection
- Haemorrhage/haematoma formation at puncture site - increased risk in service users on anticoagulant medication
What can you do to minimise the risk?
This advice presented in this article was developed in consultation with the HSE’s Antimicrobial Resistance and Infection Control team. References available on request.