A study led by the Amsterdam UMC over more than five years and 1,100 patients has demonstrated a strategy to reduce inappropriate IV use by one-third, an effect that was sustained over the entire five-year period. This should also lead to a reduction in associated infections, which affect one in ten patients. These results were published in eClinical Medicine.

“Infections from infusions and catheters occur in more than 10% of patients and studies show that up to a quarter of these are unnecessary. This simply means that patients are exposed to an unnecessarily high risk of infection. This can delay or even prevent their recovery,” says Suzanne Geerlings, Professor of Internal Medicine at Amsterdam UMC.

To counteract this, the research team published a strategy in 2017 in The Lancet Infectious DiseasesThis strategy reduced the number of unnecessary or incorrectly used catheters by 37%.

“When we talk about improper use, we usually mean catheters that have been in place for too long or, in the case of bladder catheters, inadequate support for the patient,” adds Geerlings.

Of the 1,113 patients included in the study, 962 received an intravenous catheter, which is commonly used to administer fluids, the remaining 151 received a urinary catheter, and the remaining 962 received an intravenous catheter.

“The really interesting thing is that no study has ever examined how sustainable these recommendations are, and that is true of many new strategies in the health sector. In this case, we clearly see that the effects have persisted over the last five years,” says Geerlings.

To understand why their strategy continued to work, the research team conducted interviews with 18 healthcare professionals in the Netherlands. These interviews revealed that the strategy had permanently changed workflow in four of the five hospitals studied.

“By talking to people on the ground, we learned what worked and – perhaps more importantly – what didn’t work,” says Tessa van Horrik, researcher at Amsterdam UMC and lead author of the study.

“The biggest obstacles to maintaining the strategy were a combination of other priorities, lack of time, lack of staff or both. In some cases, understandably, there was simply no one to lead the implementation over the five-year period. This shows us that the strategy can work as long as the resources are there,” adds van Horrik.

However, the study also showed that these resources do not have to be available permanently. It showed that a temporary investment in time or leadership was sufficient to reduce the unnecessary or inappropriate use of infusions and catheters.