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Giving Clinicians and Patients a Peripheral Advantage


Gregory J. Shears, MD

Lynn Hadaway, MED, RN-BC, CRNI®

After you have watched the video, you may go to and take the post-test. Upon successful completion, you may then print out your certificate.


Short peripheral IV catheters (PIVC), the most prevalent type of vascular access device (VAD), have high failure rates. Reasons are primarily related to site choices, insertion technique, and inappropriate device care during dwell. Additionally, insertion of PIVCs usually falls to clinicians with little or no formal education in this practice. To preserve peripheral veins, prevent unnecessary central VAD insertion, decrease costs, and improve satisfaction of clinicians and patients, change is certainly needed. 


Recently, the use of pre-access assessment and optimal vein site choice has evolved to considering the intraluminal relationship of catheter tip to venous structures with the help of technology.  Catheter stabilization has also advanced to include strategies to optimize angulation, limit pressure injury and reduce catheter movement.  Together this comprehensive approach should help reduce PIVC failures by linking these pieces into a more complete best practice picture.  


This interactive discussion will highlight the components of a comprehensive approach to improve these negative outcomes through education with competency assessment, pre-insertion assessment, and appropriate catheter management. 


Learning Objectives:

  1. Identify best education and training practices for competency assessment. 

  2. Analyze factors for choosing the most appropriate peripheral venous site. 

  3. Evaluate methods for assessing the venous structure.

  4. Formulate the plan of care for PIVC management during the catheter dwell time. 

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