Phlebitis Signs and Symptoms With Peripheral Intravenous Catheters: Incidence and Correlation Study

Gabor Mihala; Gillian Ray-Barruel; Vineet Chopra; Joan Webster; Marianne Wallis; Nicole Marsh; Matthew McGrail; Claire M Rickard

doi:10.1097/NAN.0000000000000288

Phlebitis Signs and Symptoms With Peripheral Intravenous Catheters: Incidence and Correlation Study

J Infus Nurs. 2018 Jul/Aug;41(4):260-263. doi: 10.1097/NAN.0000000000000288.

Authors

Gabor Mihala¹, Gillian Ray-Barruel, Vineet Chopra, Joan Webster, Marianne Wallis, Nicole Marsh, Matthew McGrail, Claire M Rickard

Affiliation

¹ School of Medicine, Griffith University, Nathan, Queensland, Australia (Mr Mihala); School of Nursing and Midwifery, Griffith University, Nathan, Queensland, Australia (Dr Ray-Barruel, Ms Marsh, Dr Rickard); Alliance for Vascular Access Teaching and Research Group (AVATAR), Menzies Health Institute Queensland, Nathan, Queensland, Australia (Mr Mihala, Dr Ray-Barruel, Ms Webster, Dr Wallis, Ms Marsh, Dr Rickard); Centre for Applied Health Economics, Menzies Health Institute Queensland, Nathan, Queensland, Australia (Mr Mihala); Division of Hospital Medicine, University of Michigan Health System, Ann Arbor, Michigan, United States (Dr Chopra); Nursing and Midwifery Research Centre, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia (Ms Webster, Ms Marsh, Dr Rickard); School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Queensland, Australia (Dr Wallis); School of Rural Health, Monash University, Churchill, Victoria, Australia (Dr McGrail); and University of Queensland, Rural Clinical School, Rockhampton, Queensland, Australia (Dr McGrail). Gabor Mihala, MEng, GCert (Biostat), is a data manager and biostatistician at the Centre for Applied Health Economics and Alliance for Vascular Access Teaching and Research (AVATAR) Group. Gillian Ray-Barruel, PhD, RN, is a leading nursing and intensive care unit researcher. She coordinated the One Million Global Catheters PIVC Worldwide Prevalence Study, which recruited more than 40 000 patients with short peripheral catheters (SPCs) around the world. She is pursuing a postdoctoral fellowship at Griffith University with the goal of improving assessment and action by bedside clinicians regarding prevention of SPC complications. Vineet Chopra, MD, MSc, is an associate professor of medicine and a research scientist at the University of Michigan and Veterans Administration Ann Arbor, Michigan Health System. His research is focused on improving the safety of infusion device use and outcomes. Joan Webster, BA, RN, is the nursing director for research at the Royal Brisbane and Women's Hospital. One of her primary research interests is intravenous access. She has authored a number of important publications in that area, including the first Cochrane review of routine versus clinically indicated removal of SPCs. Marianne Wallis, PhD, RN, FACN, is the associate dean of health at the University of the Sunshine Coast. She is a director of the AVATAR Group and a board member of the Australian Vascular Access Society. Dr Wallis's focus is on vascular access devices and therapies, specifically peripheral devices. Nicole Marsh, MAdvPrac, BN, RN, is a research fellow specializing in vascular access. She has been a clinical trial coordinator for multicenter vascular access trials since 2007. She is a PhD candidate focusing on improving insertion and maintenance of SPCs. Matthew McGrail, PhD, GradDip (IT), BSc (Hons), is a biostatistician, with expertise in analysis methods associated with clinical trials of intravascular devices. He is also a member of the AVATAR Group. Claire M. Rickard, PhD, RN, founded the AVATAR Group and is an elected Fellow of the Australian Academy of Health and Medical Sciences and the Australian College of Nursing. She has been inducted into the Sigma Theta Tau International Nurse Researcher Hall of Fame.

PMID: 29958263
DOI: 10.1097/NAN.0000000000000288

Abstract

This study was undertaken to calculate the incidence of 8 signs and symptoms used for the diagnosis of phlebitis with peripheral intravenous catheters, or short peripheral catheters, and the level of correlation between them. A total of 22 789 daily observations of 6 signs (swelling, erythema, leakage, palpable venous cord, purulent discharge, and warmth) and 2 symptoms (pain and tenderness) were analyzed of 5907 catheter insertion sites. Most signs and symptoms of phlebitis occurred only occasionally or rarely; the incidence of tenderness was highest (5.7%). Correlations were mostly low; warmth correlated strongly with tenderness, swelling, and erythema.

MeSH terms

Catheterization, Peripheral / adverse effects*
Catheters, Indwelling / adverse effects*
Device Removal
Female
Humans
Incidence
Male
Nursing Staff, Hospital
Phlebitis / diagnosis*
Phlebitis / epidemiology
Phlebitis / nursing*
Randomized Controlled Trials as Topic
Time Factors