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Background Peripheral intravenous catheters (PIVCs) contribute substantially to the global burden of infections. This systematic review assessed 24 infection prevention and control (IPC) interventions to prevent PIVC-associated infections and other complications. Methods We searched Ovid MEDLINE, Embase, Cochrane Library, WHO Global Index Medicus, CINAHL and reference lists for controlled studies, from January 1, 1980–March 16, 2023. We dually selected studies, assessed risk of bias, extracted data, and rated the certainty of evidence (COE). For outcomes with three or more trials, we conducted Bayesian random-effects meta-analyses. Results 105 studies met our prespecified eligibility criteria, addressing 16 of the 24 research questions; no studies were identified for eight research questions. Based on findings of low to high COE, wearing gloves reduced the risk for overall adverse events related to insertion compared to no gloves (one non-randomised controlled trial [RCT]; adjusted risk ratio [RR]: 0.52, 95% confidence interval 0.33–0.85), and catheter removal based on defined schedules potentially resulted in a lower phlebitis/thrombophlebitis incidence (10 RCTs; RR: 0.74, 95% credible interval 0.49–1.01) compared to clinically indicated removal in adults. In neonates, chlorhexidine reduced the phlebitis score compared to non-chlorhexidine-containing disinfection (one RCT; 0.14 versus 0.68, p = 0.003). No statistically significant differences were found for other measures. Conclusions Despite their frequent use and concern about PIVC-associated complications, this review underscores the urgent need for more high-quality studies on effective IPC methods regarding safe PIVC management. In the absence of valid evidence, adherence to standard precaution measures and documentation remain the most important principles to curb PIVC complications.
Background Peripheral intravenous catheters (PIVCs) contribute substantially to the global burden of infections. This systematic review assessed 24 infection prevention and control (IPC) interventions to prevent PIVC-associated infections and other complications. Methods We searched Ovid MEDLINE, Embase, Cochrane Library, WHO Global Index Medicus, CINAHL and reference lists for controlled studies, from January 1, 1980–March 16, 2023. We dually selected studies, assessed risk of bias, extracted data, and rated the certainty of evidence (COE). For outcomes with three or more trials, we conducted Bayesian random-effects meta-analyses. Results 105 studies met our prespecified eligibility criteria, addressing 16 of the 24 research questions; no studies were identified for eight research questions. Based on findings of low to high COE, wearing gloves reduced the risk for overall adverse events related to insertion compared to no gloves (one non-randomised controlled trial [RCT]; adjusted risk ratio [RR]: 0.52, 95% confidence interval 0.33–0.85), and catheter removal based on defined schedules potentially resulted in a lower phlebitis/thrombophlebitis incidence (10 RCTs; RR: 0.74, 95% credible interval 0.49–1.01) compared to clinically indicated removal in adults. In neonates, chlorhexidine reduced the phlebitis score compared to non-chlorhexidine-containing disinfection (one RCT; 0.14 versus 0.68, p = 0.003). No statistically significant differences were found for other measures. Conclusions Despite their frequent use and concern about PIVC-associated complications, this review underscores the urgent need for more high-quality studies on effective IPC methods regarding safe PIVC management. In the absence of valid evidence, adherence to standard precaution measures and documentation remain the most important principles to curb PIVC complications.
BACKGROUND_: _Intravenous treatment is one of the most important medical treatments and the most common invasive methods.. Phlebitis is the most common complication caused by catheters. Among the medicinal and non-medicinal methods for treating phlebitis is the use of 2% chlorhexidine solution and aloe vera gel. This study aimed to compare the effectiveness of aloe vera gel and 2% chlorhexidine gluconate solution in preventing phlebitis caused by peripheral vein catheters in hospitalized patients. METHODS: This study is a three-group clinical trial on 90 hospitalized patients who met the inclusion criteria and were randomly selected into three groups: aloe vera gel, 2% chlorhexidine solution, and the control group (30 people each). they got. Information was collected using demographic information form and phlebitis checklist. In the aloe vera gel intervention group, first the skin was disinfected with 70% ethyl alcohol, and after placing the angioket, it was fixed with glue, the upper part of which was covered with half a cc of aloe vera gel, and in the second group, the catheter was first placed with 70% ethyl alcohol. After placing the angioket with glue, its upper part was smeared with 2% chlorhexidine gel, and in the control group, only 70% ethyl alcohol disinfection catheter was inserted. The date, time and name of the researcher were recorded on the adhesive. Every 12 hours to 72 hours, the angioket insertion site in all three groups was controlled and recorded by the researcher in terms of the presence of symptoms and the degree of phlebitis. Data analysis was done with SPSS 25 statistical software at a significance level of 0.05 with chi-square tests and one-way analysis of variance. RESULTS: Both supportive treatments of aloe vera gel and chlorhexidine solution are effective in reducing the incidence of phlebitis in the intervention groups, but the frequency of phlebitis in the aloe vera group was significant compared to the control. No significant difference was observed between the aloe vera gel group and the control group at 24 and 48 hours after the intervention (p<0.05), but a statistically significant difference was observed 72 hours after catheterization (p<0.05). CONCLUSION: A comparison of the effect of 2% chlorhexidine solution and aloe vera gel showed that the incidence of phlebitis in the long term in the aloe vera gel group was lower than in the control and chlorhexidine groups. Accordingly, nurses can use non-pharmaceutical methods, including aloe vera compounds that have anti-inflammatory properties, to reduce the incidence of phlebitis during catheterization.
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