Incidence of peripheral intravenous catheter phlebitis and its associated factors among patients admitted to University of Gondar hospital, Northwest Ethiopia: a prospective, observational study

Abstract

Background Phlebitis, inflammation of tunica intima of venous wall, occurred in 13–56% of hospitalized patients. It is characterized by pain, erythema, swelling, palpable venous cord, and pussy discharge at catheter site. Cannula-related blood stream infection (CRBSI) is recognized complication of phlebitis. Adverse outcomes of phlebitis embrace patient discomfort, longer hospital stay and higher health care cost. This study aimed to determine the incidence and associated factors of peripheral vein phlebitis among hospitalized patients. Methods A hospital-based prospective, observational study was conducted between April 1 and August 31, 2020 at University of Gondar hospital, Northwest Ethiopia. A consecutive sampling method was used to recruit 384 patients. Patients were interviewed to obtain socio-demographic data. Relevant medical history and laboratory parameters were obtained from patients’ records. Presence and severity of phlebitis was identified by Jackson’s Visual Infusion Phlebitis (VIP) Scoring System. The Data were entered into EPI Info version 4.4.1 and transported to SPSS version 20 for analysis. Logistic regression analysis was used to identify associated factors with occurrence of phlebitis. P-value < 0.05 was used to declare significant association. Result A total of 384 study subjects were included in the study. The mean age of study subjects was 46 years, with a range of 19 to 96 years. The incidence of phlebitis was 70% among study subjects. Mid-stage (grade 3) and advanced-stage (grade 4) phlebitis were noticed in 136/268 (51%) and 89/268 (33%) respectively. Odds of developing phlebitis were twofold higher in patients with catheter-in situ > 96 h (AOR = 2.261, 95% CI 1.087–4.702, P-value = 0.029) as compared to those with catheter dwell time < 72 h. Female patients were 70% (AOR = 0.293, 95% CI 0.031–0.626, P-value = 0.002) lower than male patients with risk of developing phlebitis. Patients who use infusates were 53% (AOR = 0.472, 95% CI 0.280–0.796, P-value = 0.005) less likely to develop phlebitis as compared to those who didn’t use infusates. Conclusion The cannula must be reviewed on daily basis, and it should be removed if it stayed later than 96 h.

Time to Develop Phlebitis and Its Predictors among Patients with Peripheral Intravenous Cannula at Public Hospitals of Bahir Dar City, Amhara, Ethiopia, 2022: A Prospective Follow up Study

“…Patients with chronic disease were more hazardous as compared to patients free from chronic disease. This nding was similar with studies conducted in other countries (13,34). Patients with chronic diseases such as diabetes mellitus, hypertension and others are more immune-compromised that unable to resist infection/in ammation like phlebitis because they are physiological unstable as compared to healthy individual (4,25).…”

“…This was based on pre-designed phlebitis scoring form at the morning and at the evening time by data collectors to check whether the patients developed the event (phlebitis) or not developed the event. Phlebitis was diagnosed based on Jackson's Visual Infusion Phlebitis Scoring System, which is international adopted diagnosis method/criteria that has been tested in literature and used in clinical settings worldwide (13,34,37).…”

“…According to evidence, different countries have different incidence of phlebitis. The distribution of phlebitis incidence showed that in Australia 17 percent, Saudi Arabia 18 percent, Brazil 10 percent, Tunisia 52 percent, and Ethiopia 70% as evidenced by literatures (13,(16)(17)(18)(19).…”

“…The infusion nurses society indicates that the accepted phlebitis rate should be ve percent or less (11). However, still the current incidence of phlebitis is up to 70 percent following peripheral intravascular cannula use (11,13). According to evidence, different countries have different incidence of phlebitis.…”

“…There are different factors that precipitate the occurrences of phlebitis after cannula insertion. Such as high cannula gauge size, prolonged cannula dwelling time and comorbidities are the major factors that lead the patient to risk of phlebitis (13). The physiology of the vein is affected by the cannula's size and other characteristics of the cannula, which exposes the patient to phlebitis.…”