Securement methods for peripheral venous catheters to prevent failure: a randomised controlled pilot trial

Marsh, Nicole, Webster, Joan, Flynn, Julie, Mihala, Gabor, Hewer, Barbara, Fraser, John and Rickard, Claire M. (2015) Securement methods for peripheral venous catheters to prevent failure: a randomised controlled pilot trial. Journal of Vascular Access, 16 3: 237-244. doi:10.5301/jva.5000348


Author Marsh, Nicole
Webster, Joan
Flynn, Julie
Mihala, Gabor
Hewer, Barbara
Fraser, John
Rickard, Claire M.
Title Securement methods for peripheral venous catheters to prevent failure: a randomised controlled pilot trial
Journal name Journal of Vascular Access   Check publisher's open access policy
ISSN 1129-7298
1724-6032
Publication date 2015-05-01
Year available 2015
Sub-type Article (original research)
DOI 10.5301/jva.5000348
Open Access Status Not yet assessed
Volume 16
Issue 3
Start page 237
End page 244
Total pages 8
Place of publication Milan, Italy
Publisher Wichtig Publishing
Language eng
Formatted abstract
Purpose
To assess the effectiveness of four securement methods to prevent peripheral intravenous catheter (PIVC) failure.

Methods
A single-centre, four-arm, randomised, controlled, non-blinded, superiority pilot trial was conducted in a tertiary referral hospital in Queensland (Australia), between November 2012 and January 2013. Adult patients, with a PIVC expected to remain in situ for ≥24 hours and admitted to general medical or surgical wards, were randomly allocated to standard polyurethane dressing (control, SPU), tissue adhesive (TA) with an SPU, bordered polyurethane dressing (BPU) or sutureless securement device (SSD) with an SPU, experimental groups. The primary endpoint was PIVC failure, defined as premature device removal before the end of therapy because of pain, blockage, leaking, accidental removal and local or catheter-related bloodstream infection.

Results
PIVCs were used for an average of 2.6 days across all study groups (n = 85). Catheter failure was lowest in the TA group (3/21, 14%) and highest in the control group (8/21, 38%), with BPU and SSD failure at 5/20 (25%) and 5/23 (22%), respectively. The adjusted hazard ratio of catheter failure was lowest in the TA group (0.50, 95% CI: 0.13-1.98), and then the BPU (0.52, 95% CI: 0.15-1.78) and SSD (0.61, 95% CI: 0.20-1.91) groups. No patient was suspected of a local or catheter-related bloodstream infection.

Conclusions
Current SPU dressings alone do not prevent many cases of PIVC failure. TA appears promising as an innovative solution, but may not be suitable for all patients. A larger Australian National Health and Medical Research Council (NHMRC)-funded trial has commenced.
Keyword Intravenous
Occlusive dressings
Randomised controlled trial
Securement device
Tissue adhesives
Vascular access devices
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
School of Nursing, Midwifery and Social Work Publications
 
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