Abstract: Objective To investigate the application and the management issues of midline intravenous catheters in secondary or above hospitals in Hunan Province, and to provide a basis for standardizing the usage of midline catheters. Methods A cross⁃sectional survey was conducted using a self⁃designed "Survey on the Application and Management of Midline Catheters". The survey was distributed  to relevant coordinators in 89 secondary or above hospitals across 14 cities in Hunan Province, time range was from August 2023 to October 2023. Results A total of 78 hospitals (out of 89 hospitals) introduced midline catheters, most of which introduced midline catheters due to difficult peripheral venous access (83.33%, 65/78), followed by long⁃term continuous infusion therapy (75.64%, 59/78) and the application of chemotherapeutic drugs (26.92%, 21/78). In terms of evaluating the insertion length of catheters, 55 hospitals (70.51%, 55/78) used the distance of “the pre⁃puncture site along the vein to the ipsilateral clavicular line” as the predicted length for catheter insertion; 27 hospitals (34.62%, 27/78) performed catheter tip positioning; 69 hospitals (88.46%, 69/78) had a specified dwell time for midline catheters, with 62 hospitals believing the dwell time could exceed 4 weeks. A total of 28 hospitals (35.89%, 28/78) had incomplete clinical application standards and protocols for midline catheters, with 21 hospitals lacked standard operating procedures for catheter removal, 16 hospitals lacked health education protocols, and 14 hospitals lacked procedures for managing complications. A total of 66 hospitals (84.62%, 66/78) implemented quality control measures, while 12 hospitals (15.38%, 12/78) did not adopt any quality control measures. Conclusions The application of midline catheters have been popularized in secondary or above hospitals in Hunan Province, but the indications for catheter insertion are not sufficiently rational. The standard procedures for catheter insertion and maintenance need to be improved, and the quality management system requires further development and standardization.

Key words: Midline intravenous catheter, Normalization, Standardization, Intravenous therapy, Hunan