ArticleEClinicalMedicine2024
Five-year sustainability of a de-implementation strategy to reduce inappropriate use of catheters: a multicentre, mixed-methods study.
Article in EClinicalMedicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Reducing Peripheral Intravenous Catheter Use in Adult Acute Care: A Systematic Review.Emergency medicine Australasia : EMA · 2026Pooled it
- How to scale and spread catheter avoidance nationwide.BMJ quality & safety · 2025Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: The use of peripheral intravenous catheters (PIVCs) contributes to healthcare-associated infections. In 2017, we implemented a multifaceted de-implementation strategy that successfully reduced the inappropriate use of catheters in seven hospitals in the Netherlands (RICAT-1 study). Five years later, we investigated the sustainability of this strategy and the contributing factors. Methods: Multicentre mixed-methods study (RICAT-2), consisting of an observational study and interviews in five hospitals in the Netherlands from May 2022 to June 2023. We screened adult patients with PIVCs admitted to internal medicine and non-surgical subspecialty wards. We excluded patients admitted for an elective short stay or terminally ill. Primary endpoint was the percentage of inappropriate PIVCs. We used logistic regression analyses to compare RICAT-2 to the RICAT-1 baseline data. We interviewed 18 healthcare professionals and managers involved in RICAT-1 and/or quality management. We combined thematic inductive analysis and framework analysis. Findings: In RICAT-1 baseline, we included 22.0% (282/1284) inappropriate PIVCs. In RICAT-2, we included 13.8% (154/1113) inappropriate PIVCs (odds ratio 0.76, 95% CI 0.68 to 0.84, p < 0.001). We observed no association between the number of maintained strategy components and the sustained effect. For most hospitals, a small temporary investment in a de-implementation strategy was sufficient to achieve sustained effects. The main facilitator for reducing inappropriate catheters was intrinsic motivation to reduce catheter-associated infections. Main barriers were other priorities, lack of time, and not having a dedicated clinical champion. Interpretation: Since inappropriate PIVC use was still lower after five years than before the de-implementation strategy, healthcare professionals should be encouraged to adopt this strategy. Funding: This project was funded by The Netherlands Organisation for Health Research and Development (project number: 839205002).
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