{"id":53480,"date":"2026-07-08T09:50:00","date_gmt":"2026-07-08T08:50:00","guid":{"rendered":"https:\/\/campusvygon.com\/uk\/?p=53480"},"modified":"2026-06-23T11:40:10","modified_gmt":"2026-06-23T10:40:10","slug":"article-4-infection-prevention-in-iv-access-and-therapy","status":"publish","type":"post","link":"https:\/\/campusvygon.com\/uk\/vascular-access\/fundamentals-of-picc-practice\/article-4-infection-prevention-in-iv-access-and-therapy\/","title":{"rendered":"Article 4: Infection Prevention in IV Access and Therapy"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Infection prevention remains a fundamental component of safe and effective vascular access practice. Despite advances in device technology and clinical techniques, intravascular catheters continue to be a significant source of healthcare-associated infections. Loveday et al. (2015) identify that the majority of healthcare-acquired bacteraemia and septicaemia are linked to intravascular devices, highlighting the importance of stringent infection prevention measures in daily practice.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For patients requiring central venous access, including peripherally inserted central catheters (PICCs), infection can result in serious morbidity and, in some cases, mortality. As such, understanding how infections develop and how they can be prevented is essential for all clinicians involved in IV therapy.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Understanding Catheter Colonisation<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Catheter colonisation can occur via several routes, often originating from microorganisms naturally present on the skin or introduced during care and handling. The three primary routes are:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Extraluminal colonisation, where microorganisms migrate from the skin along the external surface of the catheter<\/li>\n\n\n\n<li>Intraluminal colonisation, occurring through contamination of the catheter hub or infusion system<\/li>\n\n\n\n<li>Haematogenous spread, where infection reaches the catheter from a distant site within the body<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">In addition, contaminated infusates may lead to infusate-related bloodstream infections, although this route is less common when correct preparation protocols are followed.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The organisms most frequently associated with vascular access infections include coagulase-negative staphylococci, Staphylococcus aureus, aerobic gram-negative bacilli and Candida species. These microorganisms can originate from the patient, healthcare workers or the surrounding environment.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Contributing Factors to Infection Risk<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The development of infection is rarely due to a single factor. Instead, it is often linked to a combination of clinical practice, patient-related risks and device management.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Key contributors include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Failure to maintain aseptic technique during insertion, access or maintenance<\/li>\n\n\n\n<li>Inadequate skin disinfection before insertion or during dressing changes<\/li>\n\n\n\n<li>Poor device securement leading to catheter movement and friction<\/li>\n\n\n\n<li>Suboptimal site selection, particularly areas prone to moisture, heat or flexion<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Additional risk factors include catheter type, insertion method, frequency of manipulation and the overall level of aseptic practice.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Patient-related factors also play a significant role. These include age, immunosuppression, poor nutritional status, loss of skin integrity, multiple invasive procedures and the presence of existing infections elsewhere in the body.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Local and Systemic Infections<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Catheter-related infections are typically classified into two categories:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Local infections, affecting the insertion site<\/li>\n\n\n\n<li>Systemic infections, where microorganisms enter the bloodstream and may lead to bacteraemia<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Although the incidence of bacteraemia associated with PICCs is relatively low, it can be life-threatening, particularly for immunocompromised patients. The risk increases the longer the catheter remains in situ, providing more opportunity for microbial colonisation.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Phlebitis is another commonly observed complication. While often mechanical or chemical in origin, it can increase susceptibility to infection if not identified and managed promptly. Standardised tools such as the Jackson phlebitis scale and INS infiltration scale support early recognition and intervention.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Sources of Microorganisms<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Microorganisms responsible for infection are commonly derived from the skin and the surrounding environment.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The skin hosts two types of flora:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Resident flora, which are not easily removed and include organisms such as Staphylococcus epidermidis and Staphylococcus aureus<\/li>\n\n\n\n<li>Transient flora, which are more easily transferred and colonise the surface of the skin<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Resident flora serve a protective function by competing with pathogenic organisms. However, when the skin barrier is breached during catheter insertion, these organisms can enter normally sterile areas and contribute to infection.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Environmental contamination may occur through airborne particles, including skin cells shed during normal activity, or droplets generated through coughing or movement within the clinical setting.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Routes of Microbial Entry<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Understanding the routes by which microorganisms enter the vascular system is key to prevention:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Extraluminal route: migration along the catheter surface from the insertion site<\/li>\n\n\n\n<li>Intraluminal route: contamination through the hub, lumen or infusion system during handling<\/li>\n\n\n\n<li>Haematogenous route: spread from distant infections within the body<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Each of these routes reinforces the need for consistent aseptic technique throughout the entire lifecycle of the device.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Core Principles of Infection Prevention<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">Hand Hygiene<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Effective hand hygiene remains the most important measure in preventing infection. A thorough handwashing technique includes preparation, washing, rinsing and drying, ensuring all surfaces of the hands are cleaned for a minimum of 10 to 15 seconds.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Alcohol-based hand rubs are also effective when hands are visibly clean, provided the solution is applied to all surfaces and allowed to dry completely.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Regular skin care is essential to maintain skin integrity and reduce the risk of irritation associated with frequent hand cleansing.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Aseptic Non-Touch Technique (ANTT\u00ae)<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">ANTT\u00ae is a critical approach in preventing contamination during vascular access procedures. As the skin cannot be rendered sterile, the goal is to minimise the risk of introducing microorganisms.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Surgical ANTT\u00ae is required for PICC insertion and includes the use of sterile gowns, gloves and drapes<\/li>\n\n\n\n<li>Standard ANTT\u00ae is appropriate for routine access and medication administration<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Maintaining a clean environment and ensuring only sterile equipment comes into contact with key parts are essential components of this practice.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Cutaneous Antisepsis<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The skin is the primary source of microorganisms responsible for IV-related infections, making effective skin preparation vital.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Current guidance recommends the use of chlorhexidine solutions greater than 0.5% in 70% alcohol for skin antisepsis prior to catheter insertion and during ongoing care. Proper application technique and sufficient drying time are critical to ensure effectiveness.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Supporting Safe Practice in PICC Care<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Infection prevention extends beyond insertion to include ongoing catheter management. Minimising unnecessary manipulation, maintaining securement, and adhering to standardised care protocols all contribute to reducing infection risk.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Device dwell time should be regularly reviewed, and catheters should be removed as soon as they are no longer clinically required.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Infection prevention in IV access and therapy requires a comprehensive and consistent approach. From understanding microbial sources and routes of entry to maintaining rigorous hand hygiene and aseptic technique, every step of the pathway plays a role in patient safety.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">By combining evidence-based practice with careful attention to technique and device management, clinicians can significantly reduce the risk of infection, protect vessel health and improve overall patient outcomes.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n\n\n\n<div class=\"wp-block-cover alignfull has-white-color has-text-color has-link-color has-small-font-size wp-elements-ce7d893bbfe416938deb5e35dde271ca\" style=\"min-height:200px;aspect-ratio:unset;\"><span aria-hidden=\"true\" class=\"wp-block-cover__background has-background-dim-100 has-background-dim\" style=\"background-color:#004431\"><\/span><div class=\"wp-block-cover__inner-container is-layout-flow wp-block-cover-is-layout-flow\">\n<div class=\"wp-block-media-text alignwide is-stacked-on-mobile is-vertically-aligned-center is-image-fill-element\" style=\"grid-template-columns:25% auto\"><figure class=\"wp-block-media-text__media\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"1024\" src=\"http:\/\/campusvygon.com\/uk\/wp-content\/uploads\/sites\/9\/2026\/06\/PICC-Series-front-cover-1024x1024.png\" alt=\"\" class=\"wp-image-53543 size-full\" style=\"object-position:50% 50%\" srcset=\"http:\/\/campusvygon.com\/uk\/wp-content\/uploads\/sites\/9\/2026\/06\/PICC-Series-front-cover-1024x1024.png 1024w, http:\/\/campusvygon.com\/uk\/wp-content\/uploads\/sites\/9\/2026\/06\/PICC-Series-front-cover-980x980.png 980w, http:\/\/campusvygon.com\/uk\/wp-content\/uploads\/sites\/9\/2026\/06\/PICC-Series-front-cover-480x480.png 480w\" sizes=\"(min-width: 0px) and (max-width: 480px) 480px, (min-width: 481px) and (max-width: 980px) 980px, (min-width: 981px) 1024px, 100vw\" \/><\/figure><div class=\"wp-block-media-text__content\">\n<h2 class=\"wp-block-heading has-text-align-left has-white-color has-text-color\" style=\"font-size:20px\">Ultrasound Guidance in PICC Placement<\/h2>\n\n\n\n<div class=\"wp-block-buttons alignfull is-layout-flex wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button is-style-outline is-style-outline--1\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/campusvygon.com\/uk\/vascular-access\/fundamentals-of-picc-practice\/article-5-ultrasound-guidance-in-picc-placement\/\/\">Next Article<\/a><\/div>\n<\/div>\n<\/div><\/div>\n<\/div><\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Infection prevention remains a fundamental component of safe and effective vascular access practice. Despite advances in device technology and clinical techniques, intravascular catheters continue to be a significant source of healthcare-associated infections. Loveday et al. (2015) identify that the majority of healthcare-acquired bacteraemia and septicaemia are linked to intravascular devices, highlighting the importance of stringent [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":53469,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[117],"tags":[47],"class_list":["post-53480","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-fundamentals-of-picc-practice","tag-picc-fr"],"acf":[],"_links":{"self":[{"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/posts\/53480","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/comments?post=53480"}],"version-history":[{"count":2,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/posts\/53480\/revisions"}],"predecessor-version":[{"id":53553,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/posts\/53480\/revisions\/53553"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/media\/53469"}],"wp:attachment":[{"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/media?parent=53480"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/categories?post=53480"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/campusvygon.com\/uk\/wp-json\/wp\/v2\/tags?post=53480"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}