Non-Adherence to Peripheral Venous Catheter Care Protocols Significantly Decreases Patient Safety and Impacts Costs: A Retrospective Observational Study

Abstract

In the healthcare field, the effective implementation of clinical protocols is crucial to ensuring patient safety and well-being. In this context, this study evaluates nurses' adherence to the maintenance and replacement protocol of peripheral venous catheters (PVCs) in a university hospital in Spain, examining the impact of compliance with the protocol on the loss of PVCs and on patient safety in addition to analyzing the related costs. A retrospective observational study was conducted with 590 patients who were admitted in 2018 and 2019. The chi-square test or Fisher's exact test, as appropriate, was used to see the association between the study variables; with the dependent variable being the loss of PVCs (including, as a dependent variable, the loss of PVCs before 48 h). The patients' electronic and physical medical records were reviewed to analyze nursing interventions related to the management of PVCs. A total of 24% of patients experienced PVC loss within the first 24 h after insertion. Failure to comply with the protocol resulted in 80% more catheter loss and increased the cost of cannulation by 46.84%. Low compliance with PVC care protocols significantly increases the risk of catheter loss, suggesting the need for increased training and strict protocol implementation. The findings emphasize the critical role of nursing in ensuring patient safety through adherence to evidence-based protocols. Continuing education and diligent protocol implementation are essential to reducing healthcare costs and improving patient outcomes.

Keywords: NANDA-I; adherence; cost; nursing interventions; patient safety; peripheral venous catheter; protocol; quality.

Figure 1

Selection of patients based on inclusion and exclusion criteria.

Figure 2

Data analysis. Description of the analysis flow and review of the data from the medical records in paper and computerized format.

Figure 3

Percentage of PVCs lost before 48 h and distribution of lost PVCs. (a) Number of PVCs, with respect to total, lost before and after 48 h from insertion, respectively. (b) Distribution by number of patients according to number of lost PVCs.

Figure 4

The analysis includes a comparative assessment of PVC loss by gender and across established age groups. It encompasses: (A) A comparison of PVC loss between female and male patients; (B) an analysis of adherence to PVC care and management protocols based on gender; (C) an evaluation of PVC loss in patients over 65 years of age versus those 65 years old or younger.

Figure 5

Comparison of PVC loss between patients who complied with the PVC management and care protocol and those who did not.