Implementation of the I-DECIDED® tool for PIVC assessment and decision making: discussion paper.

Abstract

Highlights: PIVCs often cause pain, irritation, or infection. Regular and careful catheter checks can decrease complications and improve patient outcomes. Implementation of the I-DECIDED® tool led to fewer idle catheters and complications. We present ideas for implementing the tool and how to overcome some common barriers.

Introduction: Peripheral intravenous catheter (PIVC) assessment and decision making should be evidence based to minimize risks and enhance patient care. Exploring implementation strategies from successful outcome studies can raise health care professionals' awareness, boost adherence to evidence-based protocols, and elevate PIVC care standards.

Aim: To describe the implementation of the I-DECIDED® device assessment and decision tool for PIVC management in the Australian and Brazilian contexts.

Methods: The Promoting Action on Research Implementation in Health Services (PARIHS) framework (evidence, context, facilitation) was used to prospectively plan the implementation of the tool in adult inpatient units in Australia and to retrospectively analyze the implementation of the tool in a pediatric inpatient unit in Brazil. Similarities and differences in the implementation studies were explored.

Results: Implementation of the tool in Australia and Brazil demonstrated that prevention and early detection of PIVC complications is achievable with standardized assessment and decision prompts. Both contexts witnessed a reduction in idle PIVCs, decreased insertion site complications, improved dressing quality, and significant improvements in documentation following implementation. Common implementation strategies included champions, education, badge cards, and posters. Enabling flexibility and context-specific education strategies was essential.

Conclusion: Standardization of PIVC assessment and decision making using the I-DECIDED® tool reduced the prevalence of idle catheters and complications in Australia and Brazil. Implementation of the tool in different contexts confirms its utility and relevance for PIVC management in diverse health care settings. Promotion and adoption of the tool as a PIVC management bundle could increase patient safety and reduce health care costs.