The research team, led by Yuanyuan Song of the Key Laboratory of Cardiovascular Nursing in Zhengzhou and Qiaofang Yang of Fuwai Central China Cardiovascular Hospital, surveyed hospitals across all 31 provinces, autonomous regions, and municipalities of mainland China in November 2023. In total, 1,945 hospitals participated, each answering an institutional questionnaire completed by a nursing administrator or an intravenous therapy lead. Because the survey captured anonymized, hospital-level data rather than individual patient records, the Ethics Committee of Beijing Hospital waived the requirement for individual informed consent, and participation was entirely voluntary. The scale of the effort is what sets it apart: few studies anywhere in the world have examined intravenous therapy organization across an entire national health system, spanning everything from small community hospitals to massive tertiary centers.

The headline result is striking. Of the 1,945 hospitals surveyed, 1,689, or 86.8 percent, reported having an established intravenous therapy team. These teams are typically composed of nurses with specialized training in vascular access who take responsibility for difficult catheter insertions, maintenance protocols, complication surveillance, and staff education. The idea behind them is straightforward: concentrating expertise in a dedicated group should reduce practice variation, standardize care, and ultimately protect patients from the complications that arise when intravenous procedures are performed inconsistently by general staff with widely differing levels of experience.

To measure technology adoption, the researchers constructed an eleven-item score covering the range of vascular-access devices and supportive technologies a hospital had available, and the mean score across all hospitals was 6.1 with a standard deviation of 2.2. To capture quality management, they defined a demanding composite outcome called full measured quality implementation, which required a hospital to perform regular quality inspections, carry out systematic data collection and analysis, and maintain a functioning complication-reporting system. Only 73.6 percent of hospitals, 1,431 in total, met all three criteria simultaneously, which underscores that even in a health system with a strong tradition of nursing quality initiatives, the complete quality-management package is far from universal.

The statistical analysis was designed to be conservative. Using multivariable ordinary least squares regression with HC3 robust standard errors for the technology score and logistic regression for the quality outcome, and restricting both models to a common complete-case sample of 1,943 hospitals, the team adjusted for hospital characteristics that might otherwise explain the apparent associations. Even after these adjustments, hospitals with an intravenous therapy team scored substantially higher on technology adoption, with a beta coefficient of 1.57 points on the eleven-item scale, a difference that is large relative to the observed mean. The 95 percent confidence interval ran from 1.29 to 1.85, and the p value was below 0.001, indicating that a result this extreme would be extremely unlikely if the true association were zero.

The quality-management association was even more dramatic. Hospitals with a dedicated intravenous therapy team had roughly four and a half times the odds of achieving full measured quality implementation compared with hospitals without one, with an odds ratio of 4.46 and a confidence interval of 3.29 to 6.06. Perhaps most tellingly, team establishment was associated with more than a sevenfold increase in the odds that a hospital had formal intravenous therapy quality evaluation standards in place, with an odds ratio of 7.16 and a confidence interval spanning 5.01 to 10.23. Formal standards are the backbone of safe vascular access practice, because they translate national guidelines into concrete local protocols covering device selection, insertion technique, dressing changes, and removal criteria.

Why should an organizational structure be so tightly linked to technology and quality metrics? The authors frame intravenous therapy teams as an organizational marker and a potential target for strengthening quality management, and the mechanistic logic is plausible on several levels. A specialized team creates a critical mass of practitioners who understand new devices well enough to advocate for acquiring them, from ultrasound-guided peripheral insertion to midline catheters and advanced securement products. Concentrated expertise also lowers the threshold for adopting technologies safely, since a device that would be risky in untrained hands becomes routine for a team that inserts hundreds of catheters a year. On the quality side, a standing team provides a natural institutional home for inspections, data systems, and complication reporting, all of which require someone with both authority and technical knowledge to maintain them.

The study’s methods deserve attention because they reflect growing sophistication in observational health-services research. The use of HC3 robust standard errors, a technique that guards against inflated statistical confidence when residual variance is heterogeneous, suggests the authors were careful about uncertainty in a dataset this large and diverse. The supplementary analyses, which include province-level coverage checks, unadjusted comparisons, domain-level technology breakdowns, organizational-resource sensitivity analyses, and sensitivity analyses around the quality-implementation thresholds, indicate that the team stress-tested its findings rather than relying on a single model specification. Reporting followed the STROBE guidelines for cross-sectional studies, and the work was funded by the Henan Medical Science and Technology Research Program Joint Construction Project, with the funder having no role in the design, analysis, or manuscript.

Still, the authors are appropriately cautious about causality. This was a cross-sectional survey, a snapshot taken at a single point in time, which means it can establish association but not temporal direction. It is possible that hospitals already committed to quality improvement are simply more likely to create intravenous therapy teams, rather than teams driving the improvement. Hospitals with teams may also differ in resources, scale, or leadership culture in ways the adjusted models could not fully capture. The researchers explicitly call for longitudinal and implementation studies to determine whether establishing teams actually precedes gains in technology adoption and quality processes, and whether these organizational changes translate into measurable differences in patient outcomes such as bloodstream infections, catheter-related thrombosis, and device dwell times.

For health systems far beyond China, the message is nonetheless compelling. Vascular access is a high-volume, high-risk activity where small improvements in organization can scale into enormous reductions in harm, and dedicated intravenous therapy teams appear to be a low-cost structural intervention associated with both modernized practice and more complete quality infrastructure. With nearly 87 percent of Chinese hospitals already adopting the model, the question facing administrators elsewhere is less whether such teams can work and more how to replicate the conditions under which they do. If future longitudinal research confirms that team establishment drives the improvements seen here, this quiet organizational reform could become one of the most cost-effective patient-safety strategies available to hospitals worldwide.

Subject of Research: Association of hospital intravenous therapy teams with technology adoption and quality management in China

Article Title: Intravenous therapy teams and their association with technology adoption and quality management: a national cross-sectional study of 1,945 hospitals in China

Article References: Song, Y., Dong, F., Jia, X., Wang, Y., Wang, L., Li, C., Yang, Q., & Liu, H. (2026). Intravenous therapy teams and their association with technology adoption and quality management: a national cross-sectional study of 1,945 hospitals in China. BMC Nursing. https://doi.org/10.1186/s12912-026-05411-3

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05411-3

Keywords: intravenous therapy, vascular access, nursing teams, quality management, technology adoption, cross-sectional study, China, patient safety, hospital management, PICC, central venous catheter, health services research