Risk factors for peripheral intravenous catheter-related phlebitis in adult patients.
Adriana Moreira Noronha Simões, Patrícia Vendramim, Mavilde Luz Gonçalves Pedreira
PMID 35724261WHAT IT FOUND
Pain at the IV site, back-of-hand insertion, reduced mobility, family history of clots, and IV amoxicillin-clavulanate or omeprazole sodium were linked to more frequent catheter-related phlebitis.
Treat insertion-site pain as a warning even without redness.
Key findings
01Pain at PIC insertion was associated with 8.3 times greater chance of phlebitis, and back-of-hand insertion with 2.8 times greater risk, in the final model.
02The final model reported odds ratios of 1.8 for reduced mobility and 22.7 for family history of venous thromboembolism.
03Use of amoxicillin-potassium clavulanate and omeprazole sodium was associated with phlebitis, with odds ratios of 7.4 and 1.7.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a secondary analysis, so it can show associations but not prove that any factor caused phlebitis. Only a small number of patients developed phlebitis, and some factors involved very few patients, so the reported odds ratios can be unstable. The analysis excluded patients with catheter-related bloodstream infection or sepsis, very low neutrophil count, or more than one catheter, so it does not apply to those groups. The sample came from different hospital sites, with most patients from one site and many surgical admissions, so results may not generalise to other settings. The risk classification model had low sensitivity, so it would not reliably identify patients who would develop phlebitis.
The easy way to misread this
Do not read the 8.3 times greater chance for insertion-site pain as proof that pain causes phlebitis or that removing a catheter because of pain alone will prevent it. This was a secondary analysis of associations among patients who already had catheters, not a test of a prevention strategy.