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Amsterdam, Netherlands – A groundbreaking study led by Amsterdam UMC has demonstrated a robust strategy for reducing inappropriate intravenous (IV) catheter use by more than a third, a success sustained over a five-year period. This research, published in eClinicalMedicine, highlights a significant breakthrough in mitigating the risks associated with unnecessary catheter use.
The study involved over 1,100 patients and revealed that inappropriate IV use, which can lead to serious infections affecting up to one in ten patients, was reduced by 37%. This decrease not only lowers the risk of infection but also enhances patient recovery times. Suzanne Geerlings, Professor of Internal Medicine at Amsterdam UMC, emphasized the importance of these findings: “Infections caused by both IVs and catheters occur in more than 10% of patients, and studies indicate that up to a quarter are not necessary. This unnecessarily high risk of infection can delay or even hamper recovery.”
The research team initially introduced their strategy in 2017 through The Lancet Infectious Diseases, which successfully reduced unnecessary catheter use by 37%. The strategy focuses on minimizing the duration of catheter use and ensuring proper indications for catheter placement, particularly for urinary catheters.
In their follow-up study, the team assessed the long-term effectiveness of this strategy across five hospitals. The study included 1,113 patients, with 962 receiving IV catheters and 151 receiving urinary catheters. Tessa van Horrik, the first author of the study, noted that this research is unique in evaluating the durability of such recommendations. “No study has previously assessed how long-lasting these strategies are, and our findings clearly demonstrate that the effects were maintained over the five-year period,” she said.
The research team conducted interviews with 18 healthcare professionals to understand why the strategy continued to be effective. These interviews revealed that the strategy had permanently altered workflows in four out of five hospitals involved in the study. However, challenges such as competing priorities, limited time, and staffing shortages were identified as barriers to consistent implementation. “By engaging with those ‘on the ground,’ we learned what worked and, perhaps more crucially, what didn’t,” van Horrik added.
Despite these challenges, the study found that temporary investments in time or leadership were sufficient to achieve significant reductions in inappropriate catheter use. This indicates that with proper resources, healthcare facilities can effectively implement and sustain such strategies.
For further details, refer to the study published in eClinicalMedicine: “Five-year sustainability of a de-implementation strategy to reduce inappropriate use of catheters: a multicentre, mixed-methods study” (DOI: 10.1016/j.eclinm.2024.102785).
Journal Information:
- Lancet Infectious Diseases
- eClinicalMedicine
