Devices and dressings to secure peripheral venous catheters to prevent complications

Marsh, Nicole; Webster, Joan; Mihala, Gabor; Rickard, Claire M

doi:10.1002/14651858.cd011070.pub2

Cited by 57 publications

(42 citation statements)

References 37 publications

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“…The release of thromboplastic substances and platelets promotes blood clotting and may cause the constriction and occlusion of the catheterized vein. This may result in the leakage of intravenous fluids from the insertion site, or their infiltration into the surrounding tissues, and subsequently impairment of venous access, as reported in our study and described in others [1,7]. The second was the soiled/unclean dressing observed during the indwell time.…”

Section: Discussionsupporting

confidence: 73%

“…The second was the soiled/unclean dressing observed during the indwell time. This situation could provide an ideal opportunity for increasing infection-producing microorganisms [1,7], especially when non-transparent dressings are used, increasing the risk of not detecting infection. In France as in other countries, guidelines recommend the use of transparent, semi-permeable polyurethane dressings [2].…”

Section: Discussionmentioning

confidence: 99%

“…This uncommon practice was associated with a reduced risk of PVCAEs in patients less than 70 years. Whether the type of dressings or new generation of safety devices is better than any other in securing PVCs would require further discussion, as pointed out in a recent review [7]. …”

Section: Discussionmentioning

confidence: 99%

“…It was considered as a fully-fledged PVCAE when it was observed in the absence of any other signs. Phlebitis, which is the irritation and inflammation of a vein wall caused by the presence of the PVC [1,7], was assessed based on Ray Maddox phlebitis grading scale [17] with minor modifications (see Table 1). The scale graded phlebitis according to five levels of severity based on the presence or absence of the following symptoms: pain at venepuncture site, erythema, swelling, induration, palpable venous cord, pus at the insertion site.…”

Section: Methodsmentioning

confidence: 99%

“…Although such devices are frequently used and often considered as presenting a low risk to the patient, PVCs are associated with significant adverse events [4,5] that may impair treatment administration and patient health. A wide range of PVC-related adverse events (PVCAEs) has been reported including partial dislodgement or accidental removal, phlebitis (irritation or inflammation to the vein wall), occlusion (blockage), infiltration (fluid moving into surrounding tissue), fluid or blood leakage and, rarely, infections [4,6,7]. So far, most studies have been focused on specific events, such as phlebitis [4,5,8–10], infiltration [5,8–10] and PVC-related infections [5,8,11–13].…”

Section: Introductionmentioning

confidence: 99%

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Peripheral Venous Catheter-Related Adverse Events: Evaluation from a Multicentre Epidemiological Study in France (the CATHEVAL Project)

et al. 2017

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IntroductionPeripheral venous catheters (PVC) are medical devices most frequently used during hospital care. Although the frequency of specific PVC-related adverse events (PVCAEs) has been reported, the global risk related to the insertion of this device is poorly estimated. The aim of this study is to determine the incidence of PVCAEs during the indwell time, after catheter removal, and to identify practice-mirroring risk factors.MethodsA prospective observational study was conducted as a part of a research project, called CATHEVAL, in one surgery ward and four medicine wards from three public general tertiary care hospitals in Northern France that were invited to participate between June-2013 and June-2014. Each participating ward included during a two-month study period all patients older than 15 years carrying a PVC. All inserted PVCs were monitored from insertion of PVC to up to 48 hours after removal. Monitored data included several practice-mirroring items, as well as the occurrence of at least one PVCAE. A multivariate Cox proportional hazard model, based on a marginal risk approach, was used to identify factors associated with the occurrence of at least one PVCAE.ResultsData were analysed for 815 PVCs (1964 PVC-days) in 573 patients. The incidence of PVCAE was 52.3/100 PVCs (21.9/100 PVC-days). PVCAEs were mainly clinical: phlebitis (20.1/100 PVCs), haematoma (17.7/100 PVCs) and liquid/blood escape (13.1/100 PVCs). Infections accounted for only 0.4/100 PVCs. The most frequent mechanical PVCAEs, was obstruction/occlusion of PVC (12.4/100 PVCs). The incidence of post-removal PVCAEs was 21.7/100 PVCs. Unstable PVC and unclean dressing were the two main risk factors.ConclusionLimitation of breaches in healthcare quality including post-removal monitoring should be reinforced to prevent PVC-related adverse events in hospital settings.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Peripheral Venous Catheter-Related Adverse Events: Evaluation from a Multicentre Epidemiological Study in France (the CATHEVAL Project)

et al. 2017

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Novel Peripheral Intravenous Catheter Securement for Children and Catheter Failure Reduction

Charters,

Foster,

Lawton

et al. 2024

JAMA Pediatr

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ImportancePeripheral intravenous catheters (PIVCs) facilitate essential treatment. Failure of these essential devices is frequent and new securement strategies may reduce failure and improve patient outcomes.ObjectiveTo evaluate clinical effectiveness of novel PIVC securement technologies for children to reduce catheter failure.Design, Setting, and ParticipantsA 3-arm, parallel group, superiority randomized clinical trial was conducted at 2 regional Australian hospitals from February 5, 2020, to January 14, 2022. Children aged 6 months to 8 years who were anticipated to require admission with a PIVC for at least 24 hours of in hospital treatment were eligible. Data were analyzed from May 25, 2022, to February 20, 2024.InterventionsParticipants were randomly allocated in a 1:1:1 ratio to standard care, bordered polyurethane (Tegaderm [3M]), integrated securement dressing (SorbaView SHIELD [Medline]), and integrated securement dressing with tissue adhesive (Secureport IV). One catheter was studied per patient.Main Outcomes and MeasuresPrimary outcome was PIVC failure, defined as premature cessation of PIVC function for any reason prior to completion of planned treatment. Secondary outcomes were PIVC complications (any time dislodgement, occlusion, infiltration, partial dislodgement, extravasation, device leaking, phlebitis, pain), PIVC longevity, intervention acceptability (clinicians, participants, caregivers; 0-10 scale), and pain on removal (participants and caregivers; 0-10 scale relevant to age), adverse events, and health care costs.ResultsA total of 383 patients (51% female; median age 36 [25th-75th percentiles, 22-72] months) were randomized 134 to standard care, 118 to integrated securement dressing, and 131 to integrated securement dressing with tissue adhesive. PIVC failure was lowest in integrated securement dressing with tissue adhesive (15 [12%]; adjusted hazard ratio [aHR], 0.47; 95% CI, 0.26-0.84) compared with integrated securement dressing (24 [21%]; aHR, 0.78; 95% CI, 0.47-1.28) and standard care (43 [34%]). Direct costs were significantly lower for integrated securement dressing with tissue adhesive (median, Australian dollars [A$], 312 [A$1 is equal to $0.65 US dollars]; IQR, A$302-A$380) and integrated securement dressing (median, A$303; IQR, A$294-A$465) compared with standard care (median, A$341; IQR, A$297-A$592; P ≤ .002) when considering the economic burden related to failure of devices. PIVC longevity and intervention acceptability were similar across all groups.Conclusions and RelevanceIn this study, PIVCs secured with integrated securement dressings and tissue adhesive, in comparison with standard care, bordered polyurethane dressings, were associated with significantly reduced PIVC failure, for children admitted to hospital via the emergency department. Further research should focus on implementation in inpatient units where prolonged dwell and reliable intravenous access is most needed.Trial RegistrationAustralian New Zealand Clinical Trials Registry Identifier: ACTRN12619001026112

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Vascular access specialist teams for device insertion and prevention of failure

Carr

Higgins

Cooke

et al. 2018

Cochrane Database of Systematic Reviews

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This systematic review failed to locate relevant published RCTs to support or refute the assertion that vascular access specialist teams are superior to the generalist model. A vascular access specialist team has advanced knowledge with regard to insertion techniques, clinical care, and management of vascular access devices, whereas a generalist model comprises nurses, doctors, or other designated healthcare professionals in the healthcare facility who may have less advanced insertion techniques and who care for vascular access devices amongst other competing clinical tasks. However, this conclusion may change once the one study awaiting classification and one ongoing study are published. There is a need for good-quality RCTs to evaluate the efficacy of a vascular access specialist team approach for vascular access device insertion and care for the prevention of failure.

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Devices and dressings to secure peripheral venous catheters to prevent complications

Cited by 57 publications

References 37 publications

Peripheral Venous Catheter-Related Adverse Events: Evaluation from a Multicentre Epidemiological Study in France (the CATHEVAL Project)

Peripheral Venous Catheter-Related Adverse Events: Evaluation from a Multicentre Epidemiological Study in France (the CATHEVAL Project)

Novel Peripheral Intravenous Catheter Securement for Children and Catheter Failure Reduction

Vascular access specialist teams for device insertion and prevention of failure

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