Journal article
Risk factors for peripheral intravenous catheter failure: a multivariate analysis of data from a randomized controlled trial
Infection Control and Hospital Epidemiology, Vol.35(1), pp.63-68
2014
PMID: 24334800
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Source: InCites
Abstract
Objective: To assess the relative importance of independent risk factors for peripheral intravenous catheter (PIVC) failure.
Methods: Secondary data analysis from a randomized controlled trial of PIVC dwell time. The Prentice, Williams, and Peterson statistical model was used to identify and compare risk factors for phlebitis, occlusion, and accidental removal.
Setting: Three acute care hospitals in Queensland, Australia.
Participants: The trial included 3,283 adult medical and surgical patients (5,907 catheters) with a PIVC with greater than 4 days of expected use.
Results: Modifiable risk factors for occlusion included hand, antecubital fossa, or upper arm insertion compared with forearm (hazard ratio [HR], 1.47 [95% confidence interval (CI), 1.28–1.68], 1.27 [95% CI, 1.08–1.49], and 1.25 [95% CI, 1.04–1.50], respectively); and for phlebitis, larger diameter PIVC (HR, 1.48 [95% CI, 1.08–2.03]). PIVCs inserted by the operating and radiology suite staff had lower occlusion risk than ward insertions (HR, 0.80 [95% CI, 0.67–0.94]). Modifiable risks for accidental removal included hand or antecubital fossa insertion compared with forearm (HR, 2.45 [95% CI, 1.93–3.10] and 1.65 [95% CI, 1.23–2.22], respectively), clinical staff insertion compared with intravenous service (HR, 1.69 [95% CI, 1.30–2.20]); and smaller PIVC diameter (HR, 1.29 [95% CI, 1.02–1.61]). Female sex was a nonmodifiable factor associated with an increased risk of both phlebitis (HR, 1.64 [95% CI, 1.28–2.09]) and occlusion (HR, 1.44 [95% CI, 1.30–1.61]).
Conclusions: PIVC survival is improved by preferential forearm insertion, selection of appropriate PIVC diameter, and insertion by intravenous teams and other specialists.
Trial Registration: The original randomized controlled trial on which this secondary analysis is based is registered with the Australian New Zealand Clinical Trials Registry (http://www.anzctr.org.au; ACTRN12608000445370).
Details
- Title
- Risk factors for peripheral intravenous catheter failure: a multivariate analysis of data from a randomized controlled trial
- Creators
- Marianne C Wallis (Author) - Griffith UniversityM McGrail (Author) - Monash UniversityJoan Webster (Author) - Griffith UniversityNicole Marsh (Author) - Griffith UniversityJ Gowardman (Author) - Royal Brisbane and Women's HospitalE Geoffrey Playford (Author) - Princess Alexandra HospitalClaire M Rickard (Author) - Griffith University
- Publication Details
- Infection Control and Hospital Epidemiology, Vol.35(1), pp.63-68
- Publisher
- University of Chicago Press; Chicago, IL
- Identifiers
- 991012926996002368
- Academic Unit
- Nursing; Faculty of Health
- Language
- English
- Resource Type
- Journal article