Centre Hospitalier Universitaire de Poitiers, Poitiers, France.
Centre Hospitalier d'Argenteuil, Argenteuil, France.
Infect Dis Now. 2024 Aug;54(5):104923. doi: 10.1016/j.idnow.2024.104923. Epub 2024 May 15.
Peripheral intravenous catheters (PIVCs) are the most commonly used invasive medical devices in healthcare. While they are often perceived as innocuous because they are common, this perception does not match their risk factors. In France, 16% of intravenous device-associated bacteremia are due to PIVCs. This consensus document reports the French experience in PIVC management, issues arising from their complications, and a proposed path toward improved PIVC care.
A panel of five French experts discussed this topic based on evidence and personal experience. A consensus process was applied to highlight the issues in need of increased awareness and to suggest possible improvements. PIVC topics were organized as General Statements, Indication, Preparation, Insertion, Maintenance, and Removal. An electronic survey was used to record agreement or disagreement; to expand the dataset, five additional French experts also answered the questions.
Out of 67 statements, 62 reached a consensus (the 80% agreement threshold was exceeded). Experts are increasingly aware that PIVCs are a significant source of complications, including local and bloodstream infections. Practices need to progress to improve patient outcomes, which will require better education for all personnel involved with the insertion and maintenance of PIVCs.
Current practice around PIVCs does not always comply with the recommendations issued. A new surveillance network targeting catheter-related healthcare-associated infections is now in place in France. Simplified, standardized, bundled solutions are needed to reduce avoidable harm from PIVCs. Healthcare practice has changed over time and new educational tools are needed to adapt to increased workload and time constraints.
外周静脉导管（PIVC）是医疗保健中最常用的侵入性医疗器械。尽管它们因其常见而被认为是无害的，但这种看法与它们的危险因素并不相符。在法国，16%的与静脉置管相关的菌血症是由 PIVC 引起的。本共识文件报告了法国在 PIVC 管理方面的经验、其并发症所引发的问题，以及改善 PIVC 护理的建议。
一个由五名法国专家组成的小组根据证据和个人经验讨论了这个话题。应用共识过程来突出需要提高认识的问题，并提出可能的改进措施。PIVC 主题分为一般陈述、适应证、准备、插入、维护和移除。电子调查用于记录同意或不同意的意见；为了扩展数据集，另外五名法国专家也回答了这些问题。
在 67 项陈述中，有 62 项达成了共识（超过 80%的同意阈值）。专家们越来越意识到 PIVC 是并发症的一个重要来源，包括局部和血流感染。为了改善患者的预后，实践需要进步，这将需要对所有参与 PIVC 插入和维护的人员进行更好的教育。
目前 PIVC 的实践并不总是符合发布的建议。法国现在已经建立了一个针对与导管相关的医疗保健相关感染的新监测网络。需要简化、标准化、捆绑的解决方案来减少 PIVC 带来的可避免的伤害。随着时间的推移，医疗保健实践已经发生了变化，需要新的教育工具来适应增加的工作量和时间限制。
