Peripheral IV Sites: Changing When Clinically Indicated Sara Lyons, Senior Nursing Student, University of New Hampshire Department of Nursing Problem: Peripheral intravenous (IV) sites are being changed inconsistently according to Frisbie Memorial Hospital (FMH) policy, which currently states “The peripheral IV site will be changed every 96 hours, immediately upon suspected contamination or within 24 hours if inserted during emergent situations.” (2016) PICO Question: In hospitalized patients with peripheral IVs, is routine changing of sites every 72-96 hours, in comparison to only when “clinically indicated,” necessary in the absence of signs of infection, phlebitis, or infiltration? Recommendations: Replace peripheral IV sites only when clinically indicated to reduce rates of unnecessary sticks, save time, and save resources. (Brown & Rowland, 2013) Clinical Implications: By implementing these changes to practice, FMH could potentially save money and time in regard to starting and maintaining peripheral IVs. (Brown & Rowland, 2013) Nursing and clinical staff at FMH would require competency in recognizing signs/symptoms of phlebitis, infection, and infiltration in peripheral IV sites. Research Implications: Research from past 20 years has shown no benefit in routinely changing peripheral IV sites every 3 – 4 days, as it may cause more harm than good. (PulmCCM Inc., 2014) There is a lack of current evidence indicating that changing IV sites and administration sets more often than a minimum frequency of 96 hours reduces the occurrence of blood stream infections if the fluids being administered contain blood, blood products, or lipids. (Gaynes & Jacob, 2019) There is currently insufficient data supporting whether or not changing IV administration sets every 96 hours or less decreases or increases rates of infection. (Gaynes & Jacob, 2019) Overall Conclusion: Further research on the subject must be conducted, as the CDC has not made changes to their practice guidelines at this point in time. Frisbie Memorial Hospital Policy “Intravenous Therapy/Saline Lock; Initiation, Ongoing Care and Discontinuation”   STANDARD OF PRACTICE 9. Replacement Frequency b. Peripheral IV site: The peripheral IV site will be changed as clinically indicated immediately upon suspected infection or phlebitis, infiltration, if necessary, contamination, or within 24 hours if inserted during emergent situations. Key Evidence: Much of nursing practice in the past adhered to the 72- 96 hour rule in regard to changing peripheral IV catheters sites. (Henry et al., 2016) CDC recommends changing peripheral IV sites every 72-96 hours. (CDC 2011) Clinically indicated means when signs and symptoms of infection, phlebitis, infiltration, or IV dislodgement are present. New studies show that changing peripheral IV sites only when “clinically indicated” does not produce significantly increased rates of infection and phlebitis. (Morrison & Holt, 2015) Pediatric clients’ IVs are only inserted once, and there are no reasons why this practice cannot be extended to adults. (Morrison & Holt, 2015)