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

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.

Catheter dwell time and risk of catheter failure in adult patients with peripheral venous catheters

“…Some studies have reported that increased dwell time may increase the risk of PVC failure in adult patients (Cicolini, Manzoli, et al, 2014a;Mermel, 2017;Sato et al, 2017), while some studies have also indicated there was no association between catheter dwell time and phlebitis (Braga et al, 2018), and catheter-related infections (Guembe et al, 2017). These inconsistent findings may be related to various confounding factors.…”

Nursing Practices in Peripheral Venous Catheter: Phlebitis and Patient Safety

“…[13][14] The purpose of the dressing is to protect the PVC insertion site against dirt, moisture 8,27 and contact with external microorganisms, in addition to minimizing the movement of the catheter within the vein and prevent displacement, thus reducing the risk of peripheral vascular trauma. 5,11,32 In the present study, the non-adhesion to the sterile, impermeable transparent dressing by the nurses made it difficult to evaluate the PVC insertion site for the presence of signs and symptoms of vascular trauma, mainly phlebitis and infiltration. In order to evaluate the insertion site, it is necessary to remove a brown colored tape.…”

“…Involving the patient in the selection of the venous catheter as well as the location and conducting educational guidelines, for example, are essential for the patient in relation to their selfcare and to prevent phlebitis and other complications related to the insertion and permanence of an intravenous catheter. 5,13 Orientation must be given to patients and their relatives about signs and symptoms of postinfusion phlebitis after PVC removal during hospital discharge, considering that the incidence of this type of phlebitis reaches values up to 11%. [30][31] The signs may develop within 48 hours, requiring evaluation by the nurse in the patients' residence or in a primary health care unit, in order to identify and implement appropriate therapeutic interventions.…”

“…[1][2][3] Its use can cause complications, which can impact the patient's safety and well-being, phlebitis being one of the most frequent complications, with incidence rates ranging from 4.5% to 60%. 2,[4][5][6][7] In view of the high incidence of phlebitis and the safety and well-being of the patient, the planning and implementation of nursing care is essential to prevent this complication during the insertion and while the PVC is in situ in the patient.…”

“…Several studies have evaluated the risk factors for complications associated with PVC, especially phlebitis, [2][3]5,[8][9] with the aim of basing nursing practices and the implementation of patient care to prevent complications. [10][11][12] The evidence highlighted in these studies is summarized in guidelines, which direct safe care associated with venous catheters.…”