The Journal of hospital infection · 2026
Nurse-led peer audits as a driver for improved peripheral intravenous catheter care and reduced bloodstream infections.
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Bogaert C, De Greve A, Verfaillie C
Аннотация
BACKGROUND: Peripheral intravenous catheters (PIVC) are widely used in acute care and are an important source of preventable peripheral line-associated bloodstream infections (PLABSI). Evidence on sustainable, nurse-led strategies to improve PIVC care and reduce PLABSI remains limited.
AIM: To describe a longitudinal multimodal quality improvement strategy combining nurse-led peer audits and real-time digital feedback to improve PIVC care and reduce PLABSI in an acute care hospital.
METHODS: A longitudinal multimodal quality improvement strategy was conducted between June 2022 and December 2025 on adult internal medicine, surgical and geriatric wards in a Belgian acute secondary care hospital. Weekly bedside audits of PIVC care bundle elements were introduced, initially led by an infection prevention and control (IPC) nurse and later transitioned to a structured nurse-led peer audit model using a digital questionnaire. Audit data were visualised in interactive dashboards alongside surveillance data.
RESULTS: A total of 6718 PIVC audits were performed. Compliance with directly observable bedside practices improved substantially, including insertion site visibility (12.7% in 2023 to >90% in 2024 and 2025) and dressing quality. Documentation- and time-dependent processes showed more limited improvement. PLABSI incidence declined progressively from 0.81 per 10,000 patient-days in 2022 to 0.29 in 2025. Several wards achieved sustained PLABSI-free periods exceeding 90 days.
CONCLUSIONS: A nurse-led peer audit strategy supported by real-time digital feedback was associated with sustained improvement in PIVC care and reduction of PLABSI incidence. Embedded within a multimodal approach, this strategy enhanced ownership and actionable feedback. Further improvement may require targeted strategies addressing time-dependent processes.
AIM: To describe a longitudinal multimodal quality improvement strategy combining nurse-led peer audits and real-time digital feedback to improve PIVC care and reduce PLABSI in an acute care hospital.
METHODS: A longitudinal multimodal quality improvement strategy was conducted between June 2022 and December 2025 on adult internal medicine, surgical and geriatric wards in a Belgian acute secondary care hospital. Weekly bedside audits of PIVC care bundle elements were introduced, initially led by an infection prevention and control (IPC) nurse and later transitioned to a structured nurse-led peer audit model using a digital questionnaire. Audit data were visualised in interactive dashboards alongside surveillance data.
RESULTS: A total of 6718 PIVC audits were performed. Compliance with directly observable bedside practices improved substantially, including insertion site visibility (12.7% in 2023 to >90% in 2024 and 2025) and dressing quality. Documentation- and time-dependent processes showed more limited improvement. PLABSI incidence declined progressively from 0.81 per 10,000 patient-days in 2022 to 0.29 in 2025. Several wards achieved sustained PLABSI-free periods exceeding 90 days.
CONCLUSIONS: A nurse-led peer audit strategy supported by real-time digital feedback was associated with sustained improvement in PIVC care and reduction of PLABSI incidence. Embedded within a multimodal approach, this strategy enhanced ownership and actionable feedback. Further improvement may require targeted strategies addressing time-dependent processes.