Intravenous (IV) therapy is a common and essential part of modern medicine, allowing fluids, medications, and nutrients to be delivered directly into a patient’s bloodstream. While generally safe, IVs carry a risk of infection if not properly maintained. Keeping an IV site clean is not just a matter of hygiene—it is a critical step in preventing potentially serious complications such as bloodstream infections, which can lead to sepsis or extended hospital stays.
There are several ways bacteria can enter the IV system. Contamination can occur during insertion if proper skin antisepsis is not performed, or afterward if the catheter site or tubing is touched with unclean hands or equipment. Even airborne microbes in a poorly maintained clinical environment can pose a risk. The longer an IV remains in place, the greater the chance of colonization by bacteria, especially if the area is not regularly disinfected 1–3.
Healthcare providers are trained to follow strict protocols when inserting and managing IVs. Before insertion, the skin is typically cleaned with a chlorhexidine solution, and sterile gloves, drapes, and equipment are used. Once in place, the IV site is covered with a sterile, transparent dressing that allows easy monitoring for signs of infection such as redness, swelling, or discharge.
Keeping an IV site clean involves regularly inspecting the site and changing dressings approximately every 5 to 7 days, or sooner if they become wet, loose, or visibly soiled. The tubing should be replaced every few days unless extended-use systems are in place. Every time medication or fluids are administered through the IV, the access ports must be disinfected to minimize contamination 4–6.
One of the most effective ways to keep an IV clean is proper hand hygiene. This applies not only to healthcare providers but also to patients and caregivers. Hands should be thoroughly washed or sanitized before touching the IV site or equipment. Patients should be encouraged to remind caregivers to clean their hands, particularly in home-care settings where formal protocols may be more relaxed 7,8.
Patients with IVs, whether in a hospital, clinic, or at home, can play an important role in keeping the site clean. They should avoid touching the IV site, keep the area dry, and immediately report any discomfort, swelling, or discharge to medical staff. Clothing or bedding should not rub against the site, and the IV arm should be protected during bathing or movement.
In outpatient or home-care scenarios, patients may be trained on how to monitor and clean the area themselves or with the help of a nurse. Clear instructions and routine follow-ups are key to ensuring safety in these less-controlled environments 9–12.
Keeping an IV clean is a shared responsibility between healthcare providers and patients. With careful technique, regular monitoring, and a commitment to cleanliness, the risk of IV-related infections can be significantly reduced. In medical care, something as simple as clean hands and proper disinfection can be the difference between a quick recovery and a life-threatening complication.
References
1. Cunha, B. A. Intravenous line infections. Crit Care Clin 14, 339–346 (1998). DOI: 10.1016/s0749-0704(05)70399-7
2. Macias, A. E. et al. Contamination of intravenous fluids: A continuing cause of hospital bacteremia. American Journal of Infection Control 38, 217–221 (2010). DOI: 10.1016/j.ajic.2009.08.015
3. Haddadin, Y., Annamaraju, P. & Regunath, H. Central Line–Associated Blood Stream Infections. in StatPearls (StatPearls Publishing, Treasure Island (FL), 2024).
4. Munoz-Mozas, G. Preventing intravenous catheter-related bloodstream infections (CRBSIs). British Journal of Nursing (2023). DOI: 10.12968/bjon.2023.32.Sup7.S4
5. Guidelines for the prevention of bloodstream infections and other infections associated with the use of intravascular catheters: part I: peripheral catheters. https://www.who.int/publications/i/item/9789240093829.
6. CDC. Background Information: Strategies for Prevention of Catheter-Related Infections in Adult and Pediatric Patients. Infection Control https://www.cdc.gov/infection-control/hcp/intravascular-catheter-related-infection/prevention-strategies.html (2024).
7. Mathur, P. Hand hygiene: Back to the basics of infection control. Indian J Med Res 134, 611–620 (2011). DOI: 10.4103/0971-5916.90985
8. O’Grady, N. P. et al. Guidelines for the Prevention of Intravascular Catheter-related Infections. Clin Infect Dis 52, e162–e193 (2011). DOI: 10.1093/cid/cir257
9. Buetti, N. et al. Strategies to prevent central line-associated bloodstream infections in acute-care hospitals: 2022 Update. Infect Control Hosp Epidemiol 43, 553–569. DOI: 10.1017/ice.2022.87
10. Bell, T. & O’Grady, N. Prevention of Central Line-Associated Bloodstream Infections. Infect Dis Clin North Am 31, 551–559 (2017). DOI: 10.1016/j.idc.2017.05.007
11. Park, J. Y. Implementing a central venous catheter self-management education program for patients with cancer. European Journal of Oncology Nursing 25, 1–8 (2016). DOI: 10.1016/j.ejon.2016.08.010
12. Hedge, C. NHIA Statement on Infection Control Surveillance in Home Infusion. National Home Infusion Association https://nhia.org/nhia-statement-on-infection-control-surveillance-in-home-infusion/ (2023).
