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Quality and Safety in the Literature: March 2022
  1. Irina Khurana1,
  2. Ashwin Gupta1,2,
  3. Nathan Houchens1,2
  1. 1 Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
  2. 2 Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Irina Khurana, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 48109, USA; ikhurana{at}

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Key points

  • Replacing peripheral intravenous catheters only when clinically indicated is associated with more bloodstream infections as compared with routine replacement. JAMA Intern Med 17 September 2021.

  • Penalties levied by the End-Stage Renal Disease Quality Incentive Program pay-for-performance programme do not improve performance scores of dialysis facilities. Ann Intern Med August 2021.

  • Point-of-care procalcitonin testing for acute respiratory tract infection in the outpatient setting leads to reduced antibiotic prescribing without affecting safety. BMJ 21 September 2021.

Healthcare quality and safety span multiple topics across the spectrum of academic and clinical disciplines. Keeping abreast of the rapidly growing body of work can be challenging. In this series, we provide succinct summaries of selected relevant studies published in the last several months. Some articles will focus on a particular theme, whereas others will highlight unique publications from high-impact medical journals.

Comparison of routine replacement with clinically indicated replacement of peripheral intravenous catheters

JAMA Intern Med 17 September 2021

Most patients receive intravenous medications or fluid during a hospital stay; indeed, placement of a peripheral intravenous catheter (PVC) is the most common procedure for hospitalised patients.1 Over 300 million PVCs are placed each year in the USA,2 and it is estimated that globally, the number tallies over 1 billion.3 While PVCs are often considered to pose a low risk of adverse events, they are associated with complications such as phlebitis, bloodstream infection (BSI) and extravasation.4

Despite ubiquitous PVC use and known preventable complications, the frequency with which PVCs should be replaced remains unclear. The US Centers for Disease Control and Prevention signals that there is no indication for replacement of PVCs more frequently than every 72–96 hours,5 and the US-based Infusion Nurses Society’s 2021 standards of practice suggest replacement of PVCs when clinically indicated (eg, with PVC malfunction or symptoms such as pain or phlebitis).6 While several studies have examined the …

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  • Twitter @irinak05, @ashwin_b_gupta, @nate_houchens

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests AG and NH are employed by the US Department of Veterans Affairs.

  • Provenance and peer review Not commissioned; internally peer reviewed.