PP9 -Audit of peripheral intravenous cannula (PIVC) site maintenance practices and PIVC associated phlebitis occurrence at selected government hospitals in Sri Lanka.

Abstract

Introduction

Peripheral intravenous catheters (PIVCs) are the most used invasive medical devices in hospitals. Peripheral intravenous cannula site phlebitis is one of the healthcare-associated infections that can be prevented by correct cannula insertion and maintenance practices.

 Objectives

The study was designed to assess the PIVC site maintenance practices and associated phlebitis occurrence at selected government hospitals in Sri Lanka.

 Design, setting, and methods

The audit was conducted among patients at five hospitals: District General Hospital Avissawella, Teaching Hospital Batticaloa, District General Hospital Embilipitiya, Teaching Hospital Polonnaruwa, and Base Hospital Puttalam, from February 2025 over a period of five days. All patients in the ward at the time of the audit were included, excluding those sent in for referrals and investigations. Data on the number of patients who were cannulated, number of cannulas with written inserted date, number of dates from the insertion of a cannula, number of well-kept cannulas (cleaned, well attached), number of the cannulas with signs of cannula site infection (pain, erythema, swelling, warmth, tenderness) and number of cannula sites with features of infection once removed, were collected using a paper-based worksheet.

 Results

Of the 2,556 patients audited, 77.07% (n = 1,970) were cannulated at the time of the audit. Out of 1999 cannulas (from 1970 patients), 81.69% of PIVCs (n = 1633) were dated, and 88.04% (n = 1760) were well-maintained. Of the dated cannulas, 11.70% (n = 191) were kept for more than three days. There were 4 in situ cannulas with signs of cannula site infection, and 151 (7.66%) patients had cannula sites with signs of phlebitis. 

 Conclusion

PIVC use among the study population is noted to be high. While documentation of insertion dates was good, 11.70% of cannulas remained in situ for more than three days, potentially increasing the risk of complications. Maintenance practices varied across hospitals, although the overall percentage of well-maintained cannulas was high.  The results highlight the need for standardized PIVC maintenance protocols to improve patient safety.