Risk factors for peripheral intravenous catheter-related phlebitis in adult patients

Abstract

Objective: To identify risk factors for peripheral intravenous catheter-related phlebitis in adult patients. Method: This is a post hoc analysis of a randomized clinical trial, totaling 1,319 patients. Demographic and clinical variables related to therapy and phlebitis were investigated. For data analysis, frequencies, measures of central tendency and dispersion were calculated, and Pearson’s chi-square test and Fisher’s exact test were used, with logistic regression, ROC curve, and Odds Ratio calculation (95% confidence interval; 5% significance level) being implemented. Results: Of the 1,319 participants, 80 (6.1%) developed phlebitis. The following were associated with the occurrence of phlebitis: reduced mobility (p = 0.015), family history of deep vein thrombosis (p = 0.05), catheterization of veins on the back of the hand (p = 0.012), pain (p < 0.01), Amoxicillin-Potassium Clavulanate (p = 0.015), and Omeprazole Sodium (p = 0.029). Conclusion: Risk factors for phlebitis involved intrinsic and extrinsic factors to the patient, indicating preventive nursing interventions such as promoting patient mobility, not catheterizing veins in the dorsal arch of the hand, cautious infusion of risk drugs, and valuing pain complaints.

Peripheral Intravenous Catheter Insertion

“…Seventy-seven percent did not wait for the antiseptic to dry, 62% performed back-and-forth movements, and 53% touched the insertion site after antisepsis. 15 INS recommends using the Aseptic Non Touch Technique (ANTT®) for PIVC insertion. This technique consists of a specific and comprehensive set of infection prevention actions that aim to protect patients from infection during invasive clinical procedures and management of medical devices.…”

“…In all of them, the professionals dilated the vein using only the latex procedure glove. 15 In the scoping review on the same topic, the evidence gathered indicated that health care professionals do not follow a pattern of tourniquet use and do not comply with principles established in international guidelines. The lack of a pattern contributes to the contamination of the tourniquet and with potential implications for the quality, safety, and effectiveness of care.…”

“…They found that 21% used 0.5% alcoholic chlorhexidine and 79% used alcohol for skin antisepsis at the catheter insertion site. Seventy-seven percent did not wait for the antiseptic to dry, 62% performed back-and-forth movements, and 53% touched the insertion site after antisepsis 15…”

“…In one study, 60 procedure PIVC insertions were assessed. In all of them, the professionals dilated the vein using only the latex procedure glove 15. In the scoping review on the same topic, the evidence gathered indicated that health care professionals do not follow a pattern of tourniquet use and do not comply with principles established in international guidelines.…”

Agreement on actions to be taken and their respective importance in the assessment, treatment and follow-up of phlebitis secondary to peripheral venous catheterisation: a Delphi study at national level in Spain

“…Therefore, pain is an indispensable indicator of possible PVC-related complications. Nurses can visually verify some signs, but other symptoms reported by the patient may be considered less reliable, such as irritation, and potentially more related to a possible adverse effect of the administration of certain intravenous drugs (29,30) and not to PVC phlebitis. Irritation was the item of the Assessment dimension with the highest CV (100%) in this study.…”