Phlebitis prevention protocol

Noorul Amin; Sajad Hussain Naik

doi:10.33883/jms.v26i1.1253

Noorul Amin Sher i Kashmir Institute of Medical Sciences Soura Srinagar
Sajad Hussain Naik

DOI: https://doi.org/10.33883/jms.v26i1.1253

Keywords: Cannula, Phlebitis, Prevention protocol, Peripheral veins

Abstract

Peripheral venous cannulation has revolutionised the practice of drug administration. It is a common practice carried out in hospitals to allow infusion of medications, hydration fluids, blood products and nutritional supplements.

Along with the benefits, a number of potential complications are associated with IV cannulation, ranging from minor pain to severe thrombophlebitis and catheter related infections.

Infection control plays a vital role in health care practices but unfortunately it is often the under-recognised and under supported part of the health care system. It is one of the oldest problems in the history of medical practice and currently it is posing new challenges to medical profession. According to WHO, 1 in every 10 patients get an infection while receiving health care. Most of the patients admitted in the hospital are given some medications intravenously by inserting a catheter. Intravenous catheters cause trauma to the vascular endothelium and inflammation. Peripheral catheter-related phlebitis is caused by the inflammation of the tunica intima of a superficial vein. The inflammation is due to irritation of the tunica intima by mechanical, chemical or bacterial sources. If left untreated, it can lead to infection or thrombus formation. Many studies have concluded that thrombophlebitis is one of the most frequently associated complications of peripheral vein infusion, occurring in up to a fourth of hospitalised patients receiving intravenous therapy.

Therefore nursing staff has a responsibility to minimise the incidence of phlebitis, at the same time ensuring that patients receive treatment in an appropriate and timely manner. Nurse’s knowledge of intravenous cannulation process and early recognition of risk factors for the development of phlebitis can reduce incidence of phlebitis.

Downloads

Download data is not yet available.

References

O'Grady N, Alexander M, Burns L, Dellinger E, Garland J, Heard S, et al. Healthcare Infection Control Practices Advisory Committee (HICPAC). Guidelines for the prevention of intravascular catheter-related infections. 2011.
ACSQHC. Australian Guidelines for the Prevention and Control of Infection in Healthcare.
National Health and Medical Research Council; 2010.
Marschall J, Mermel L, Fakih M, Hadaway L, Kallen A, O'Grady N, et al. Strategies to prevent central line-associated bloodstream infections in acute care hospitals: 2014 update. Infection Control and Hospital Epidemiology. 2014;35(7):753-71.
Sacks G, Diggs B, Hadjizacharia P, Green D, Salim A, Malinoski D. Reducing the rate of catheter-associated bloodstream infections in a surgical intensive care unit using the Institute for Improvement central line bundle. The American Journal of Surgery.2014;207(6):817-23.
Carson D, Dychter S, Gold D, Haller M. Intravenous therapy: a review of complications and economic considerations of peripheral access. Journal of Infusion Nursing. 2012;35(2):84-9
Morris W, Tay M. Strategies for preventing peripheral intravenous cannula infection. BritishJournal of Nursing. 2008;17(19): S14-S21.
Rivera A, Strauss K, Van Zundert A, Mortier E. Matching the peripheral intravenous catheter to the individual patient. Acta Anaesthesiologica Belgica. 2007; 58:19-25.
ACSQHC. Standard for credentialling and defining the scope of clinical practice. AustralianCommission on Safety and Quality in Health Care. 2004.
Queensland Government. Health service directive # QH-HSD-034:2014 Credentialing and defining the scope of clinical practice. 2014.
Fakih M, Jones K, Rey J, Berriel-Cass D, Kalinicheva T, Szpunar S, et al. Sustained improvements in peripheral venous catheter care in non-invasive care units: a quasi- experimental controlled study of education and feedback. Infection Control and Hospital Epidemiology. 2012;33(5):449-55.
Health Protection Scotland. Targeted literature review: What are the key infection prevention and control recommendations to inform a peripheral vascular catheter (PVC) maintenance care quality improvement tool. 2012.
McIntyre H, Raw A, Stephenson J, Bradley A, Dawson J, Fay M, et al. NICE quality standard 61: Infection prevention and control. National Institute for Health and Care Excellence; 2014.
McCallum L, Higgins D. Care of peripheral venous cannula sites. Nursing Times.2012;108(34):12-5.
Trinh T, Chan P, Edwards O, Hollenbeck B, Huang B, Burdick N, et al. Peripheral venous catheter-related staphylococcus aureus bacteremia. Infection Control and Hospital Epidemiology. 2011;32(6):579-83.
Salgueiro-Oliveira A, Veiga P, Parreira P. Incidence of phlebitis in patients with peripheral intravenous catheters: the influence of some risk factors. Australian Journal of Advanced Nursing. 2013;30(2):32-9.