Phlebitis and infiltration: vascular trauma associated with the peripheral venous catheter

Luciene Muniz Braga, Pedro Miguel Parreira, Anabela de Sousa Salgueiro Oliveira, Lisete Dos Santos Mendes Mónico, Cristina Arreguy-Sena, Maria Adriana Henriques, Luciene Muniz Braga, Pedro Miguel Parreira, Anabela de Sousa Salgueiro Oliveira, Lisete Dos Santos Mendes Mónico, Cristina Arreguy-Sena, Maria Adriana Henriques

Abstract

Objective: to determine the incidence rate and risk factors for the nursing-sensitive indicators phlebitis and infiltration in patients with peripheral venous catheters (PVCs).

Method: cohort study with 110 patients. Scales were used to assess and document phlebitis and infiltration. Socio-demographic variables, clinical variables related to the PVC, medication and hospitalization variables were collected. Descriptive and inferential analysis and multivariate logistic models were used.

Results: the incidence rate of phlebitis and infiltration was respectively 43.2 and 59.7 per 1000 catheter-days. Most PVCs with these vascular traumas were removed in the first 24 hours. Risk factors for phlebitis were: length of hospital stay (p=0.042) and number of catheters inserted (p<0.001); risk factors for infiltration were: piperacillin/tazobactan (p=0.024) and the number of catheters inserted (p<0.001).

Conclusion: the investigation documented the incidence of nursing-sensitive indicators (phlebitis and infiltration) and revealed new risk factors related to infiltration. It also allowed a reflection on the nursing care necessary to prevent these vascular traumas and on the indications and contraindications of the PVC, supporting the implementation of the PICC as an alternative to PVC.

References

    1. Pujol M, Hornero A, Saballs M, Gudiol F. Clinical epidemiology and outcomes of peripheral venous catheter-related bloodstream infections at a university-affiliated hospital. J Hosp Infect. 2007;67(1):22–29. doi: 10.1016/j.jhin.2007.06.017.
    1. Johann DA, Danski MTR, Vayego SA, Barbosa DA, Lind J. Risk factors for complications in peripheral intravenous catheters in adults secondary analysis of a randomized controlled trial. Rev. Latino-Am. Enfermagem. 2016;24:e2833. doi: 10.1590/1518-8345.1457.2833.
    1. New KA, Webster J, Marsh NM, Hewer B. Intravascular device use, management, documentation and complications a point prevalence survey. Aust Health Rev. 2014;38(3):345–349. doi: 10.1071/AH13111.
    1. Fernández-Ruiz M, Carretero A, Díaz D, Fuentes C, González JI, García-Reyne A. Hospital-wide survey of the adequacy in the number of vascular catheters and catheter lumens. J Hosp Med. 2014;9(1):35–41. doi: 10.1002/jhm.2130.
    1. Pérez-Granda MJ, Guembe MR, Rincón C, Muñoz P, Bouza E. A prevalence survey of intravascular catheter use in a general hospital. J Vasc Access. 2014;15(6):524–528. doi: 10.5301/jva.5000272.
    1. Chopra V, Flanders SA, Saint S, Woller SC, O'Grady NP, Safdar N. The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) results from a multispecialty panel using the RAND/UCLA appropriateness method. Ann Intern Med. 2015;163(6 Suppl):S1–40. doi: 10.7326/M15-0744.
    1. González López JL, Arribi Vilela A, Fernández del Palacio E, Olivares Corral J, Benedicto Martí C, Herrera Portal P. Indwell times, complications and costs of open vs closed safety peripheral intravenous catheters a randomized study. J Hosp Infect. 2014;86(2):117–126. doi: 10.1016/j.jhin.2013.10.008.
    1. Xavier PB, Oliveira RC, Araújo RS. Peripheral venous puncture: local complications in patients assisted in a university hospital. Rev Enferm UFPE on line. 2011;5(1):61–66. doi: 10.5205/1981-8963-v5i1-2011.
    1. Danski MTR, Oliveira GLR, Johann DA, Pedrolo E, Vayego SA. Incidence of local complications in peripheral venous catheters and associated risk factors. Acta Paul Enferm. 2015;28(6):517–523. doi: 10.1590/1982-0194201500087.
    1. Saini R, Agnihotri M, Gupta A, Walia I. Epidemiology of infiltration and phlebitis. NMRJ. 2011;7(1):22–33.
    1. Urbanetto JS, Peixoto CG, May TA. Incidence of phlebitis associated with the use of peripheral IV catheter and following catheter removal Rev. Latino-Am. Enfermagem. 2016;24:e2746. doi: 10.1590/1518-8345.0604.2746.
    1. Athayde AGP, Oliveira ADM. Study of the integration of signs in making peripheral catheter related phlebitis judgments. Rev Enferm Ref. 2006;(3):7–19.
    1. Braga LM, Salgueiro-Oliveira AS, Henriques MAP, Rodrigues MA, Rodrigues CJV, Pereira SAG. Translation and adaptation of the Phlebitis Scale for the Portuguese population. Rev Enferm Ref. 2016;SerIV(11):101–109. doi: 10.12707/RIV16048.
    1. Salgueiro Oliveira A, Parreira P, Veiga P. Incidence of phlebitis in patients with peripheral intravenous catheters: The influence of some risk factors. Aust J Adv Nurs. 2012;30(2):32–39.
    1. Brady Boyce BA, Yee BH. Incidence and severity of phlebitis in patients receiving peripherally infused amiodarone. Crit Care Nurse. 2012;32(4):27–34. doi: 10.4037/ccn2012139.
    1. Furtado LCR. Incidence and predisposing factors of phlebitis in a surgery department. Br J Nurs. 2011;20(Suppl7):S16–S25. doi: 10.12968/bjon.2011.20.Sup7.S16.
    1. Uslusoy E, Mete S. Predisposing factors to phlebitis in patients with peripheral intravenous catheters a descriptive study. J Am Acad Nurse Pract. 2008;20(4):172–180. doi: 10.1111/j.1745-7599.2008.00305.x.
    1. Dahal P, Shrestha JM. Extravasation injury of the upper limb by intravenous clindamycin. PMJN. 2011;11(2):51–53.
    1. Braga LM, Salgueiro-Oliveira AS, Henriques MAP, Arreguy-Sena C, Parreira PMSD. Transcultural adaptation of the Infiltration Scale into the Portuguese culture. Acta Paul Enferm. 2016;29(1):93–99. doi: 10.1590/1982-0194201600013.
    1. Casanova D, Bardot J, Magalon G. Emergency treatment of accidental infusion leakage in the newborn report of 14 cases. Br J Plast Surg. 2001;54(5):396–399. doi: 10.1054/bjps.2001.3593.
    1. Schummer W, Schummer C, Bayer O, Müller A, Bredle D, Karzai W. Extravasation injury in the perioperative setting. Anesth Analg. 2005;100(3):722–727. doi: 10.1213/01.ANE.0000154442.30278.3C.
    1. Rose REC, Felix R, Crawford-Sykes A, Venugopal R, Wharfe G, Arscott G. Extravasation injuries. West Indian Med J. 2008;57(1):40–47.
    1. Lira SA, C A., Neto Correlation coefficient derived from Pearson linear coefficient for ordinal and dichotomic variables. RECIE. 2006;15(1/2):45–53.
    1. Dekkers OM, Egger M, Altman DG, Vandenbroucke JP. Distinguishing case series from cohort studies. Ann Intern Med. 2012;156(1):37–40. doi: 10.7326/0003-4819-156-1-201201030-00006.
    1. Rojas-Sánchez LZ, Parra DI, Camargo-Figuera FA. Incidence and factors associated with development of phlebitis: results of a pilot study cohort. Rev. Enferm Ref. 2015;(4):61–67. doi: 10.12707/RIII13141.
    1. Pasalioglu KB, Kaya H. Catheter indwell time and phlebitis development during peripheral intravenous catheter administration. Pak J Med Sci. 2014;30(4):725–730.
    1. Park SM, Jeong IS, Kim KL, Park KJ, Jung MJ, Jun SS. The effect of intravenous infiltration management program for hospitalized children. J Pediatr Nurs. 2016;31(2):172–178. doi: 10.1016/j.pedn.2015.10.013.
    1. Vaismoradi M, Jordan S, Kangasniemi M. Patient participation in patient safety and nursing input - a systematic review. J Clin Nurs. 2015;24(5-6):627–639. doi: 10.1111/jocn.12664.

Source: PubMed

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