Which action can be performed to prevent the risk of dislodging the catheter during IV therapy?

September 27, 2025 •

5 min read

According to research, accidental intravenous (IV) catheter dislodgement is a common and often underestimated issue, affecting millions of catheters annually and costing billions in healthcare. A crucial action that can be performed to prevent the risk of dislodging the catheter during IV therapy is proper securement of the device at the insertion site with appropriate materials and techniques.

Quick Summary

Ensuring the IV catheter is properly and consistently secured is the most vital step to prevent dislodgement, which involves selecting the right securement method, such as sterile dressings or engineered stabilization devices, and applying it correctly to minimize movement and tension on the line. This practice reduces patient discomfort and prevents complications like infiltration, infection, and treatment delays.

Key Points

Proper Securement: Meticulously and consistently securing the IV catheter with high-quality dressings or engineered devices is the most critical action to prevent dislodgement.
Standardized Protocols: Implementing and enforcing standardized policies for IV insertion and maintenance ensures consistency and reduces risks across all clinical staff.
Patient Education: Informing patients about the importance of protecting their IV site and reporting any issues helps to minimize accidental tugging and line interference.
Correct Site Selection: Avoiding high-flexion areas, like wrists, during catheter placement reduces movement and strain on the device.
Regular Site Assessment: Frequent and thorough checks of the IV site and dressing for any loosening, damage, or signs of complication are essential for early intervention.
Advanced Technology: Utilizing engineered stabilization devices or breakaway connectors provides enhanced security beyond traditional taping methods, especially for high-risk patients.

Understanding the Problem: Why IV Catheter Dislodgement is a Risk

IV therapy is a cornerstone of modern medical treatment, but it is not without risks. Accidental dislodgement of the IV catheter is one of the most common and potentially serious complications. When a catheter comes out of the vein prematurely, it can lead to a cascade of problems, including:

Delay in Treatment: The immediate interruption of medication or fluid delivery can halt critical therapies.
Patient Discomfort and Anxiety: Restarting an IV is an uncomfortable, and sometimes difficult, procedure that adds to patient stress.
Risk of Complications: Dislodgement can lead to infiltration (fluid leaking into surrounding tissue), hemorrhage, and an increased risk of infection, as the insertion site's sterile field is compromised.
Vascular Trauma: Frequent IV restarts can damage the patient's veins, making future access more challenging.

Addressing the root causes, which often include patient movement, confused patients, or improperly secured lines, is essential for proactive patient care. The solution lies in a multi-faceted approach centered on vigilant and standardized securement techniques.

The Critical Action: Securement and Stabilization

The single most effective action to prevent accidental IV catheter dislodgement is meticulous and consistent securement. Proper securement techniques prevent the catheter from being pulled out by external forces or micro-movements, which can irritate the vein and cause failure. This involves using the correct materials and following best practices for application.

Best Practices for Securement

Proper Site Preparation: Before applying any securement, the skin around the insertion site must be clean, dry, and free of oils or lotions. The use of a skin protectant barrier can improve dressing adhesion, especially for patients with delicate skin. For hairy areas, clipping (not shaving) the hair ensures the dressing has a secure contact with the skin.
Use of Engineered Stabilization Devices: While medical tape and transparent dressings are common, engineered stabilization devices (ESDs) are recommended by guidelines like the Infusion Nurses Standards of Practice for superior securement. These devices are specifically designed to anchor the catheter hub and tubing, reducing movement at the insertion site.
Correct Dressing Application: A sterile, transparent semi-permeable dressing should be applied over the insertion site. It is crucial to apply the dressing smoothly, without stretching or causing tension on the skin, and to ensure no gaps or wrinkles exist.
Addressing Tubing Tension: Excess tubing should be managed to avoid creating tension on the catheter. Using an additional securement device or tape to loop and secure the tubing away from the insertion site can prevent accidental pulling.

Beyond Securement: Comprehensive Preventive Strategies

Securement is the foundation, but a holistic approach to IV therapy safety includes several other important measures.

Comparison of Securement Techniques


Feature	Transparent Dressing & Tape	Engineered Stabilization Device (ESD)	Breakaway Connector System	Medical-Grade Tissue Adhesive
Securement Strength	Varies, dependent on tape quality and technique. Prone to loosening with moisture and movement.	High, specifically designed to anchor the hub and tubing.	High, prevents damage by disconnecting before extreme force is applied.	High, effectively immobilizes the catheter hub and prevents micromovement.
Risk of Micromovement	Moderate to High, especially in active patients or with loosened adhesive.	Low, engineered to minimize movement at the insertion point.	Low, prevents tension from reaching the catheter tip.	Very Low, 'glues' the catheter hub to the skin.
Best for Patient Type	General population, short-term infusions.	Ideal for active, agitated, or confused patients.	Excellent for restless or confused patients where accidental pulling is a major risk.	Suitable for patients with fragile skin or high-risk for dislodgement.
Infection Risk	Potential risk if non-sterile tape is used near the site or if dressing becomes loose.	Helps maintain sterile field better than standard tape.	Maintains aseptic integrity by sealing both tubing ends upon disconnection.	May reduce infection risk by minimizing micromovement and potential colonization.
Ease of Removal	Generally easy, but can cause skin damage if not removed carefully.	Varies by design, but generally designed for patient comfort during removal.	Designed for quick, clean detachment in emergency situations.	Requires special adhesive remover and careful technique to avoid skin trauma.

Nursing Protocol and Education

Continuous education for clinical staff on proper insertion, securement, and assessment protocols is crucial. Standardization of practices across an institution ensures every clinician is trained to manage IV catheters in the same, consistent way. Regular auditing of IV sites to check for signs of failure, proper dressing, and securement is also vital.

Patient Monitoring and Engagement

Patients and their families should be educated on the importance of protecting the IV site. Encouraging patients to report any discomfort or changes at the site and reminding them to be mindful of the line during movement, especially when getting out of bed or using the bathroom, can significantly reduce accidental tugs.

Innovative Technologies

New technologies continue to be developed to address the issue of dislodgement. Breakaway connector systems, for example, feature a safety release valve that disconnects if undue pressure is applied, protecting the catheter and sealing the tubing to prevent spills. While not yet widely commercialized, such innovations hold great promise for the future of IV therapy safety.

The Role of Site Selection and Maintenance

Initial site selection plays a preventative role. Avoiding areas of flexion, such as the wrist or antecubital fossa, can reduce the strain on the catheter caused by normal joint movement. For long-term or high-risk patients, a central venous access device (CVAD) may be a more stable alternative.

Regular and thorough assessment of the IV site is a non-negotiable part of maintenance. Nurses should check the site for any signs of complications, including loosening dressing, redness, swelling, or pain. As per guidelines, transparent dressings should be changed at least every seven days, or immediately if they become damp, soiled, or loose.

Conclusion

While many factors contribute to IV dislodgement, the most direct and controllable preventive action is proper securement. Through meticulous site preparation, utilizing appropriate securement methods—including advanced engineered devices—and employing standardized nursing protocols, healthcare providers can dramatically reduce the risk of accidental catheter displacement. This commitment to procedural excellence not only protects the patient's vein health but also ensures the seamless delivery of critical IV therapy, minimizing complications and improving overall outcomes.

For more detailed information on preventing catheter-related infections and other IV best practices, consult the official guidelines provided by health organizations such as the Centers for Disease Control and Prevention.

Frequently Asked Questions

The primary and most critical action is the proper and consistent securement of the catheter at the insertion site, using appropriate sterile dressings and stabilization devices to minimize any movement or tension on the line.

While tape and transparent dressings are common, they may not provide sufficient securement for all patients, especially those who are confused, restless, or have fragile skin. Engineered stabilization devices are often recommended for better outcomes and reduced risk of dislodgement.

Ensuring the skin is clean, dry, and free of oils or hair before applying the dressing allows for maximum adhesion. Poor skin preparation can cause the dressing to loosen quickly, increasing the risk of the catheter coming out.

If an IV dressing becomes loose, damp, or soiled, it must be replaced immediately to prevent dislodgement and reduce the risk of infection. The nurse should perform hand hygiene, maintain aseptic technique, and apply a new, secure dressing.

Yes, patient movement is a very common cause of catheter dislodgement. Accidental pulls, catching the tubing on bed rails, or simply rolling over can exert enough force to dislodge the catheter, especially if the securement is not adequate.

Engineered stabilization devices (ESDs) are specialized products designed to securely anchor the IV catheter and tubing to the skin. They offer more stability than traditional tape and dressings and are recommended for use to improve securement outcomes.

Yes. Avoiding areas of high movement, such as joints like the wrist or elbow, can significantly reduce the mechanical stress on the catheter and help prevent accidental dislodgement.