Phlebitis
Conditions
Keywords
Phlebitis/etiology, Infusions, Intravenous/adverse effects, Randomised controlled trial, Phlebitis/prevention, Adult, Time factors
Brief summary
The purpose of this study is to investigate the effects of extending the dwell time of peripheral intravenous cannulas on clinical outcomes and cost.
Detailed description
Among hospitalized patients, intravenous therapy is the most common invasive procedure. It is associated with a phlebitis rate of between 1.1% and 63% and a central venous catheter related bacteremia rate of approximately 3.0%. Catheter related blood-stream infections have an attributable mortality rate of 12% to 25%. Factors thought to be associated with these complications include insertion techniques, catheter securement, type of catheter used, type of infusate and additives, post-insertion catheter care and length of time the catheter remains in place. Current Centers of Disease Control Guidelines provide direction for intravenous therapy management including a recommendation that peripheral intravenous catheters should be re-sited every 72-96 hours. Data underpinning the recommendation was collected in 1992, over a decade ago. Since that time, there have been improvements in catheter design and composition, and prospective surveillance studies have demonstrated the safety of longer dwell times. To date, these observations have not been validated in adults, using randomized controlled trial methodology. Re-siting intravenous cannulas causes discomfort to patients and has a high recurrent cost. The primary aim of the present study is to compare the rates of peripheral catheter-related blood stream infection, catheter-related local infection, phlebitis and obstruction between two groups of patients - those having routine catheter changes every 72 hours and those having catheter changes only when clinically indicated. Specific hypotheses: That changing intravenous peripheral catheters when indicated by clinical signs compared to changing intravenous catheters every 3 days reduces the incidence of intravenous catheter related morbidity.
Interventions
PROCEDUREExtending peripheral intravenous (IV) cannula dwell times
Sponsors
Royal Brisbane and Women's Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients are eligible to join the Peripheral Venous Catheter Trial if: * They are inpatients at the Royal Brisbane and Royal Women's Hospital who are at least 18 years of age AND * They are scheduled or expected to have a peripheral venous catheter indwelling for at least 4 days. AND * They have had their catheter inserted by a nurse from the IV Therapy Team
Exclusion criteria
* Patients with an existing bloodstream infection * Those receiving immunosuppressive treatment
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Phlebitis during the course of the infusion and up to 48 hours after peripheral venous catheter removal | — |
Secondary
| Measure | Time frame |
|---|---|
| Infiltration permeation of IV fluid into the interstitial compartment | — |
| Local infection at the site of the catheter | — |
| Catheter-related blood stream infection | — |
| Catheter colonization | — |
| Cost | — |
Countries
Australia
Outcome results
None listed