Implementation of a peripheral intravenous catheter bundle to reduce phlebitis and hospital-onset

Background: Peripheral intravenous catheters (PIVCs) are widely used in hospitals and account for up to one-third of hospital-onset Local Problem: In response to increasing HO-SAB, a quality improvement initiative was launched to reduce PIVC-related phlebitis and HO-SAB. Methods: An evidence-based bundle for peripheral intravenous catheter (PIVC) insertion and care was developed, focusing on four key components: hand hygiene, aseptic technique during insertion, daily monitoring and timely removal of PIVCs, and optimization of maintenance care. The bundle was piloted in two wards using the Model for Improvement, which led to a reduction in phlebitis rates. The same PIVC bundle was subsequently implemented in a phased manner across the hospital, with the implementation process guided by Kotter's 8-step model of change to ensure effective and sustainable adoption. Interventions: Interventions involved staff education, daily PIVC checks, process and outcome monitoring with feedback, ongoing ward engagement, and hospital-wide awareness campaigns. Key implementation measures included bundle compliance, phlebitis rates, and PIVC-related HO-SAB. Results: Phlebitis rates in pilot wards declined from 7% to 1-2%, with comparable reductions observed after hospital-wide implementation. PIVC-related HO-SAB rates decreased from 0.61 (pre-implementation) to 0.26 episodes per 10,000 patient-days. Conclusions: Overall, the structured care bundle significantly reduced phlebitis and was associated with lower PIVC-related HO-SAB rates.