Risk factors for peripheral intravenous catheter failure: a multivariate analysis of data from a randomized controlled trial

Wallis, Marianne C., McGrail, Matthew, Webster, Joan, Marsh, Nicole, Gowardman, John, Playford, Geoffrey and Rickard, Claire M. (2014) Risk factors for peripheral intravenous catheter failure: a multivariate analysis of data from a randomized controlled trial. Infection Control and Hospital Epidemiology, 35 1: 63-68. doi:10.1086/674398

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Author Wallis, Marianne C.
McGrail, Matthew
Webster, Joan
Marsh, Nicole
Gowardman, John
Playford, Geoffrey
Rickard, Claire M.
Title Risk factors for peripheral intravenous catheter failure: a multivariate analysis of data from a randomized controlled trial
Journal name Infection Control and Hospital Epidemiology   Check publisher's open access policy
ISSN 0899-823X
1559-6834
Publication date 2014-01-01
Year available 2013
Sub-type Article (original research)
DOI 10.1086/674398
Open Access Status File (Publisher version)
Volume 35
Issue 1
Start page 63
End page 68
Total pages 6
Place of publication New York, NY, United States
Publisher Cambridge University Press
Language eng
Formatted 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.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Electronically published: 2 December 2013.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Nursing, Midwifery and Social Work Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 28 times in Thomson Reuters Web of Science Article | Citations
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Created: Wed, 15 Jan 2014, 00:08:58 EST by Vicki Percival on behalf of School of Nursing, Midwifery and Social Work