Clinically indicated replacement versus routine replacement of peripheral venous catheters in adults: A nonblinded, cluster‐randomized trial in China

Xu, Lichun; Hu, Yan; Huang, Xiaohang; Fu, Jianguo; Zhang, Jinhui

doi:10.1111/ijn.12595

Cited by 22 publications

(26 citation statements)

References 23 publications

(57 reference statements)

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“…Similarly, the current data demonstrate that the increasing dwell time of PVCs did not increase the frequency of phlebitis. 4,5,7,8,11 In a study conducted by Miliani et al, 12 a negative correlation was established between the dwell time of catheter and the risk of PVC-related complications. Another study showed that the risk of catheter failure may not remain constant throughout the dwell time, and the risk of PVC failure did not increase after the first 38 h. 13 A recent Cochrane review found no difference in phlebitis and infection risk between routine replacement and clinically indicated removal.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the risk factors on time to phlebitis- and nonphlebitis-related failure when peripheral venous catheters were replaced as clinically indicated

et al. 2020

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Background: This study aimed to determine the frequency of peripheral venous catheter–related complications and the risk factors that have an impact on the time of peripheral venous catheter failure when they were replaced as clinically indicated. Methods: This was a prospective observational study. The demographic and clinical characteristics of the patients, as well as the catheter specifications, were recorded. All the catheters were followed-up at 12-h intervals for the development of complications. Two different peripheral venous catheters were used in the study. The catheter dwell times were estimated using Kaplan–Meier analysis. The logrank test was utilized to investigate the catheter dwell times by univariate analyses. Variables with a significance level of less than 0.20 were taken into Cox regression analysis. Results: Our results revealed that phlebitis and nonphlebitis complications occurred more frequently within the first 96 h. No significant difference was observed in the occurrence time of phlebitis, nonphlebitis, and composite failures. The use of a locally manufactured catheter, unsuccessful first attempt, poor skin integrity, after-hours’ insertion, the use of sterile gauze dressing were all associated with shorter catheter survival rates. Conclusion: We observed no difference on the time to phlebitis or nonphlebitis symptoms with clinically indicated replacement of peripheral venous catheters. We found a significant difference in survival rates between locally manufactured and imported peripheral venous catheters. Our identified risk factors should be taken into account to reduce peripheral venous catheter–related complications and to increase dwell time.

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Section: Discussionmentioning

confidence: 99%

“…On the positive side, clinically indicated replacement of PVC can result in a longer dwell time without complication. 4 –8 However, many risk factors related to the patient (e.g. age, immunodeficiency, diabetes mellitus, skin elasticity, vascular quality), the catheter (e.g.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the risk factors on time to phlebitis- and nonphlebitis-related failure when peripheral venous catheters were replaced as clinically indicated

et al. 2020

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“…Berdasarkan bukti penelitian yang ada, kebijakan saat ini untuk penggantian rutin 72-96 jam tidak efektif dan perlu dilakukan kebijakan penggantian IV karena indikasi klinis. Penelitian oleh Xu, Hu, Huang, Fu, & Zhang (2017), bahwa penggantian kateter IV dengan indikasi klinis dapat mengurangi ketidaknyamanan pasien. Dalam menerapkan penggantian IV karena indikasi klinis, ada hal penting yang harus yang dilakukan petugas yaitu memantau pemasangan IV secara teliti setiap hari untuk menilai tentang perlunya terapi IV dilanjutkan atau segera dilakukan penggantian/ pelepasan bila ditemukan indikasi klinis (Rickard, McCann, Munnings, & McGrail, 2010).…”

Section: Pembahasanunclassified

“…Salah satu kinerja yang dimaksud adalah mentaati SPO yang berlaku di rumah sakit. Salah satunya adalah SPO pergantian infus secara rutin setiap 3 hari, padahal pergantian dengan indikasi klinis lebih efektif dan efisien seperti yang dikemukakan oleh Xu et al, (2017), bahwa penggantian kateter IV dengan indikasi klinis dapat mengurangi beban kerja perawat. Selain itu menurut (Wu & Casella, 2013), bahwa pergantian selang intravena yang dilakukan secara klinis mengurangi beban kerja untuk staf klinis dan biaya perawatan kesehatan.…”

Section: Pembahasanunclassified

Replacement Peripheral Intravenous Catheters With Clinical Indication for Patient Convenience, Cost Efficiency and Reducing Nurses Workload

Nurmawan

Djafar

Hakim³

et al. 2018

ICON

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Introduction: PIVCs (Peripheral Intravenous Catheters) have been widely used for clinical medical care which is having risk for phlebitis occurence. IV catheter replacement is performed when there is clinical indication such us phlebitis. The consequence of this action is patient convinence, nurse workload and patient care cost efficiency. Methode: A longitudinal study with experimental results of evidence based practice on replacement of PIVSc with clinical indication as an effort to improve patient convinience, cost efficiency and reduce nurse workload in 41 patients. Result: 41 patients attached PIVCs, 100% wanted IV catheter replacement if there was any clinical indication. 68% of patients said very uncomfortable if IV catheter routinely replaced. 16 nurse (56.25%) said there is no need to replace IV catheter regularly. 43.75% of nurses felt IV catheters rountine replacement increased the working time and 50% of the nurses felt that nurses workload was increased. Conclusions: IV catheter replacement can be performed if there is cinical indication because it can improve patient convenience, increase cost efficiency and reduce nurse workload.

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“…CF negatively affects the patient's comfort and continuous fluid therapy. Catheter replacement, which is unavoidable in CF, increases patient discomfort (8,9), labor costs, and the cost of medical resources (3,(10)(11)(12)(13)(14). For these reasons, it is important to prevent CF in PIVCs and to pay special attention to signs, symptoms, and changes in the infusion rate.…”

Section: Introductionmentioning

confidence: 99%

Catheter tips are a possible resource for biological study on catheter failure

Takahashi

Minematsu

Murayama

et al. 2019

DD&T

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Few studies have investigated the molecular mechanisms of catheter failure (CF). Herein, we performed histological and molecular biological analyses of the catheter tip to demonstrate its potential as a resource for biological investigation. Additionally, we searched for risk factors for the development of inflammation and coagulation, which are pathological conditions clarified by biological analysis. The CF group included 30 failed catheters involving thrombus and subcutaneous edema identified by ultrasonography. The No-CF group included 26 catheters with no complications. The removed catheter tips were fixed for hematoxylin-eosin (HE) staining with the application of a real-time reverse transcriptase polymerase chain reaction for eukaryotic 18S ribosomal RNA (rRNA), interleukin 1β, tumor necrosis factor α, tissue plasminogen activator, and plasminogen activator inhibitor 1 (SERPINE1). HE staining identified attached nuclear cells on the inner surfaces of both CF and No-CF catheters. The 18S rRNA was amplified in all samples. The expression level of SERPINE1 was significantly higher in the CF group than in the No-CF group (p = 0.01), whereas the expression levels of other genes did not differ between the groups. Symptoms of CF associated with the expression of SERPINE1 were analyzed. The catheter being in contact with blood vessels during placement was a suggested factor related to the high expression of SERPINE1 (p = 0.04). Catheter tips are a potential resource for biological investigation, and expression analysis of the attached cells can reflect the pathological condition of the catheterized tissue. Further studies using catheter tips are required to elucidate the molecular mechanisms of CF.

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Clinically indicated replacement versus routine replacement of peripheral venous catheters in adults: A nonblinded, cluster‐randomized trial in China

Abstract: Clinically indicated PIVC replacement is feasible, and it may reduce nursing staff workload and patient discomfort.

Cited by 22 publications

References 23 publications

Evaluation of the risk factors on time to phlebitis- and nonphlebitis-related failure when peripheral venous catheters were replaced as clinically indicated

Evaluation of the risk factors on time to phlebitis- and nonphlebitis-related failure when peripheral venous catheters were replaced as clinically indicated

Replacement Peripheral Intravenous Catheters With Clinical Indication for Patient Convenience, Cost Efficiency and Reducing Nurses Workload

Catheter tips are a possible resource for biological study on catheter failure

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