Abstract
Background: Vascular access devices (VADs) are essential in modern clinical practice but are associated with significant risks including catheter-related bloodstream infections (CRBSIs). The use of continuous intravenous infusion through a closed system like TKVO (To Keep Vein Open) has been proposed as a strategy to reduce these risks.
Aim: This case study explores the effectiveness of continuous intravenous infusion using a burette compared to intermittent infusion for reducing bloodstream infections among adult patients, based on clinical experiences across two Australian healthcare systems supported by high-level evidence.
Methods: This study applied the 6S evidence hierarchy to evaluate evidence from systematic reviews, randomized controlled trials, and expert guidelines. Personal clinical observations from Northern Territory and Queensland Health settings provided contextual background.
Results: Evidence indicates that continuous infusion helps maintain catheter patency, reduces manipulation of VADs, and may lower infection rates. However, high-level statistical data directly comparing infection rates between continuous and intermittent methods remain limited. Implementation barriers include equipment availability, reduced patient mobility, and contraindications in certain patient populations.
Conclusion: Continuous infusion using TKVO may reduce infection risk and improve patient safety when appropriately implemented. More rigorous research is required to strengthen the evidence base and policy guidelines development across Australian healthcare settings.