Optimal Timing for Peripheral Intravenous Cannula Replacement

Aladeen Alloubani1, *, Mohammad Awwad2, Laila Akhu-Zaheya3
1 Nursing Research & EBP Unit, King Hussein Cancer Center, Jordan and Harvard Medical School, United States
2 Nursing Administration, King Hussein Cancer Center, Jordan
3 Faculty of Nursing, Jordan University of Science and Technology, and King Hussein Cancer Center, Jordan

© 2019 Alloubani et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Nursing Research & EBP Unit, King Hussein Cancer Center, Jordan; Tel: +962795777178; E-mail:



Current literature indicates the optimal replacement time of an intravenous catheter, ranges from when “clinically indicated” (i.e. signs of complications such as infection, occlusion, and/or phlebitis) to three days. The time constraint is designed to prevent infection(s) and phlebitis, as well as to decrease the costs of healthcare, and the time spent by nurses, on patient care.


To evaluate the impact of routine removal and re-siting of the peripheral intravenous catheter removal, compared to removal when “clinically indicated” by adults and/or pediatrics.

Search Strategy:

A search for literature was conducted via Cochrane Review and Web of Sciences™ Core Collection, MEDLINE, and PubMed to summarise the optimal timing for peripheral intravenous cannula replacement. One reviewer individually evaluated the trial(s), review(s), quality of the guidelines, and then, extracted the data.

Selection Criteria:

Criteria included guideline(s); randomized controlled trial(s); and reviews; all of which matched routine removal of peripheral intravenous cannulation, with re-sited when “clinically indicated”, only in patients in the hospital, partaking in intravenous medication and/or fluids. Articles of relevance to the topic, published in English, French, or Portuguese, prior to 2018, were reviewed.


The effective implementation of evidence-based, guideline-based practice can decrease the catheter-related infection risk. While larger multi-site trials are required, present-day evidence asserts: the repetitive inserting of a peripheral intravenous device may raise the patient’s level of discomfort, increase the costs of healthcare, and does not decrease complications associated with peripheral intravenous devices.

Implications for Practice:

The clinically indicated intravenous catheter replacement procedure is cost-effective, compared with the recurring replacement procedure, which recurs every 72 hours; it has been suggested that healthcare institution(s) and hospital(s) have considered revising the policy, whereby intravenous catheters are replaced, if clinically indicated, only.

Keywords: Cannula replacement, Catheter-related bloodstream infection, Clinically indicated, Infection, Phlebitis, Peripheral intravenous catheter removal.