Dressings and securements for the prevention of peripheral intravenous catheter failure in adults (SAVE): a pragmatic, randomised controlled, superiority trial

Rickard, Claire M; Marsh, Nicole; Webster, Joan; Runnegar, Naomi; Larsen, Emily; McGrail, Matthew Richard; Fullerton, Fiona; Bettington, Emilie; Whitty, Jennifer A.; Choudhury, Abu; Tuffaha, Haitham; Corley, Amanda; McMillan, David; Fraser, John F.; Marshall, Andrea P.; Playford, E Geoffrey

doi:10.1016/s0140-6736(18)31380-1

Cited by 131 publications

(170 citation statements)

References 29 publications

(33 reference statements)

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“…The appropriateness guide does not address the choice between PVCs and midline catheters. The median dwell times for PVCs have been reported at 2‐6 days . Hence, the advantages in selecting midline catheters with an approximate mean dwell time of 14 days before premature removal seem obvious, despite their increased price.…”

Section: Discussionmentioning

confidence: 99%

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The clinical performance of midline catheters—An observational study

Madsen

Sloth

Illum

et al. 2019

Acta Anaesthesiol Scand

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Background The use of peripheral venous catheters (PVCs) is hampered by short dwell time, and central venous catheters (CVCs) are often preferred for medium‐ to long‐time intravenous treatment. Ultrasound techniques allow for easy catheter insertion into the major veins of the upper arm. A new generation of midline catheters, PowerGlide Pro, utilises a one‐hand Seldinger technique and can be inserted by one single operator without assistance. This study aimed to evaluate the clinical performance of the PowerGlide Pro midline catheter. Methods Consecutively inserted midline catheters were followed in a prospective, observational quality control study. Endpoints were dwell time, the incidence of premature catheter removal, causes of catheter removal and the dwell time and incidence rates of predefined subgroups representing potential effect modifiers. Results Hundred midline catheters, of which 98 were accessible to follow‐up, were inserted in 70 patients. Median dwell time was 8 days and 60 catheters were removed before the indication for intravenous therapy had ceased. The overall incidence for premature catheter removal was 71.8/1000 days and no significant effects of subgroups (sex, body mass index, catheter reinsertions, significant comorbidity, anticoagulant therapy, irritant infusions) were identified for either dwell time or the incidence rate for premature midline catheter removal. The most frequent reasons for premature catheter removal were pain during infusion, clotted catheter or signs of infection. Conclusion The median dwell time of the midline catheters was 8 days with substantial variation, whereas the incidence for premature catheter removal was 71.8/1000 catheter days. The majority of midline catheters were removed prematurely.

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Section: Discussionmentioning

confidence: 99%

“…Intravenous therapy is an integral part of most hospital admissions. The majority of patients receive a peripheral venous catheter (PVC), as this catheter type is easily inserted and has a low complication rate . However, its use is seriously hampered by as short median dwell time of only 2‐6 days with considerable variation.…”

Section: Introductionmentioning

confidence: 99%

The clinical performance of midline catheters—An observational study

Madsen

Sloth

Illum

et al. 2019

Acta Anaesthesiol Scand

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“…Peripheral venous catheter failure refers to various complications that necessitate PIVC removal caused by issues related to PVC insertion or management, such as dislodgement, phlebitis, infiltration, occlusion and infection (Marsh et al, ; Rickard et al, ). Chinese guidelines recommend regularly changing PVCs every 72 ~ 96 hr to reduce the risk of PIVC failure, and Swedish guidelines recommend regularly changing PVCs every 72 hr, with the exception of children and patients with difficult access (Vårdhandboken, ).…”

Section: Introductionmentioning

confidence: 99%

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

Wei

Yue

et al. 2019

Journal of Clinical Nursing

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Aims and objectives To explore whether the risk of peripheral venous catheters failure remained constant throughout catheter use in adult patients. Background Peripheral venous catheters, widely used in adult patients, may have a critical threshold dwell time associated with increased risk of catheter failure. Design Prospective, observational study. We have complied with the STROBE checklist of items. Methods This study was conducted from July–October 2018 in Hunan, China. Data on patient factors, catheter factors and catheter failure events were collected. Poisson regression was used to assess the effect of catheter dwell time on catheter failure while adjusting for other variables. Results A total of 1,477 patients were included in the analysis. There were 854 cases (57.8%) of catheter failure. The median dwell time to catheter failure was 52 hr (interquartile range: 36–73 hr). The incidence rate of catheter failure significantly increased by 1.1%/h in the first 38 hr after catheter insertion. From 39–149 hr, the incidence rate significantly decreased, and at >149 hr, there was no significant change in the incidence rate. Meanwhile, factors such as vascular quality and infused drugs showed having an impact on catheter failure events. Conclusions The risk of catheter failure may not remain constant throughout the dwell time. The results suggest that nurses should assess the insertion site frequently in the first 38 hr. Relevance to clinical practice The significant increase in the risk of catheter failure per hour may warrant close and frequent inspection of insertion site during the first 38 hr.

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“…According to INS, transparent dressings should not be relied upon to act as the single source of securement indicating the lack of supportive evidence (Gorski et al 2016). Results of the study by Rickard et al (2018) demonstrated similar dislodgement outcomes (7-10%) for transparent dressings, bordered transparent, adhesive sutureless securement, and transparent and tissue adhesive with transparent dressing (Rickard et al 2018). While the tissue adhesive and transparent dressing had the lowest dislodgement (7%), the results were not statistically significant.…”

Section: Transparent Dressingsmentioning

confidence: 99%

Right Securement, Dressing, and Management

Hill

Moureau²

2019

Vessel Health and Preservation: The Right Approach for Vascular Access

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This chapter considers the role of securement in CVAD care, providing an overview of the background and how knowledge and research has evolved in this area. The complications of inadequate securement such as infection, migration, pistoning, and medical adhesiverelated skin injury (MARSI) are examined to understand contributing factors that lead to their development. Practices that enhance optimal securement and mitigate risks are discussed as part of the clinician's role in the prevention of complications in our endeavor to reach our ultimate goal of achieving zero CVAD complications.

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Dressings and securements for the prevention of peripheral intravenous catheter failure in adults (SAVE): a pragmatic, randomised controlled, superiority trial

Abstract: Australian National Health and Medical Research Council.

Cited by 131 publications

References 29 publications

The clinical performance of midline catheters—An observational study

The clinical performance of midline catheters—An observational study

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

Right Securement, Dressing, and Management

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