Complications associated with peripheral intravenous devices : a prospective study in an acute orthopaedic unit

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Complications associated with peripheral intravenous devices : a prospective study in an acute orthopaedic unit


Author: Tse, Chi Chung
Title: Complications associated with peripheral intravenous devices : a prospective study in an acute orthopaedic unit
Degree: M.Sc.
Year: 2012
Subject: Injections, Intravenous.
Intravenous therapy.
Hong Kong Polytechnic University -- Dissertations
Department: Faculty of Health and Social Sciences
Pages: xii, 69 p. : ill. ; 30 cm.
Language: English
InnoPac Record:
Abstract: Objective: This pilot study aimed to compare the complication rates between two re-site practices of peripheral intravenous devices (IVD). The two practices were routine re-site practice and clinically-indicated practice. Study design: The design was a prospective study. Data were collected from 1st December 2011 to 31st January 2012 in an orthopaedic unit of a general hospital. The exposure variables were the two IVD re-site practices and the outcome variables were the IVD-related phlebitis and other complications. Method: Patients who had one or more IVD insertions were included. They received IVD insertion in one of the following practices: a) If the patient had limited venous access, the IVD was not changed until it was clinically indicated. b) The IVD was changed at least every 72-96 hours according to routine practice. Nurses were trained to perform the IVD re-site procedures and document the results in the health records. The complications were measured by using the Visual Infusion Phlebitis (VIP) Score for phlebitis and the presence and absence of infiltration and occlusion. Results: During the study period, 377 patients received IVD insertion with 235 patients qualified to be included in the study. Among them, 148 received the routine re-site practice and 87 the clinically indicated re-site practice. The cumulative incidence of the IVD-related complications in the routine practice group was 14.19% and that of the clinically indicated practice group was 20.69% per 2 months. The difference between the two rates was not statistically significant (X²=1.673, df=1, p=0.196). The relative risk of IVD-related complications comparing the routine and clinically indicated practices was 0.686. Conclusion: The results should be interpreted with caution because the integrity of the findings was affected by poor guideline adherence. A total of 37.67% of the patients were excluded from data analysis because the nurses did not adhere to the clinical guidelines or document the IVD outcomes. A modification of education methods to improve nurses' behavior in IVD-related care should be considered. Further study should design better education methods and evaluate its impact on the change in guideline adherence and patient outcome.

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