Impact and Safety Associated with Accidental Dislodgement of Vascular Access Devices: A Survey of Professions, Settings, and Devices
Background: Dislodgement rates with intravenous catheters are reported at 1.8%–24% events per year resulting in failed access, interrupted treatment, and greater resource consumption with catheter replacement. The purpose of this study was to quantitatively evaluate the perceptions of frequency, impact, contributing factors, and safety issues from accidental dislodgement affecting intravenous (IV) devices as reported by healthcare clinicians.
Methodology: A cross-sectional descriptive survey was conducted via a voluntary online web-based survey of clinicians. Subjects were divided as those actively working in a clinical healthcare setting and those no longer active. Analysis of data was performed quantifying responses of clinicians on question of dislodgement.
Results: Survey results indicate clinicians routinely observe a significant percentage of accidental dislodgement, with 68% of the 1561 respondents reporting often, daily, or multiple times daily occurrence and 96.5% identifying peripheral intravenous catheters as most common device experiencing accidental dislodgement. Respondents prioritized 10 contributing factors, with confused patient (80%), patient physically removes catheter (74%), and IV catheter tape or securement loose (65%) as the top 3 causes. Over 95% of respondents consider IV dislodgement a safety risk to patients.
Conclusions: This study reports perceptions and impact of accidental dislodgement with IV devices. Inconsistencies exist with use, application, and management of catheter securement and dressings for IV catheters. Risk of additional complications and complete device failure are increased when dislodgement occurs. Given possible complications, along with necessitating replacement of the IV device in many cases, IV catheter dislodgement was considered a safety risk to patients by nearly all respondents.Abstract
How often do you see accidental dislodgement of any IV catheter?
Which types of catheters have you seen accidentally dislodge? (multiple answers allowed). CVC, central venous catheter; PICC, peripherally inserted central catheter; PIV, peripheral intravenous.
How often does an accidental dislodgement occur (by catheter type)? CVC, central venous catheter; PICC, peripherally inserted central catheter; PIV, peripheral intravenous.
In your experience or research, are IV catheters accidentally dislodged even when securement/stabilization devices are used? IV, intravenous; PICC, peripherally inserted central catheter; VA, vascular access.
What are the consequences of accidental catheter dislodgement? (multiple choices allowed). IV, intravenous; VA, vascular access.
On average, how much time is spent replacing a short peripheral catheter that was accidentally dislodged? IV, intravenous; PICC, peripherally inserted central catheter; VA, vascular access.
What are the most common contributors of accidental dislodgement? (multiple choices allowed). IV, intravenous.
Rate the following statement: “Accidental dislodgement is considered a safety risk for patients experiencing sudden (partial or complete) removal of a catheter.” IV, intravenous; PICC, peripherally inserted central catheter; VA, vascular access.
Accidental dislodgement is a significant, unaddressed problem at my facility in providing continuous care for patients for the following catheter: CVC, central venous catheter; PICC, peripherally inserted central catheter; PIV, peripheral intravenous.
Contributor Notes
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