A GAVeCeLT-IVAS bundle for safe insertion of short peripheral catheters: The SISPeC protocol

Short peripheral catheters (SPC) are the most widely used peripheral venous access devices in clinical practice. Despite being a relatively simple procedure, their placement is associated with a high rate of complications, including multiple venipunctures, phlebitis, dislodgement, occlusion, and, even if to a lesser extent, local and bloodstream infections. Recent studies suggest several strategies and techniques that, if adopted systematically, may reduce the incidence of both early and late catheter-related complications. This paper describes a structured, sequential insertion bundle - developed by the Italian Group of Long-Term Venous Access Devices (GAVeCeLT) and by the Italian Vascular Access Society (IVAS)-designated SISPeC (Safe Insertion of Short Peripheral Catheters), which consists of six evidence-based steps aiming to minimize complications related to SPC insertion in adults and children: (1) pre-procedural examination of both arms with and without tourniquet; (2) choice of the most appropriate site of venipuncture, preferably avoiding area of flexion (wrist, antecubital fossa) and choosing-when feasible-veins at the forearm or the cephalic vein at the upper arm; (3) appropriate hand hygiene and skin antisepsis; (4) puncture and cannulation of the vein by the cannula-over-needle technique, preferably using a tourniquet; (5) connection to the administration set; (6) appropriate securement of the device and protection of the exit site.