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Vascular Access/IV

Peripheral intravenous catheter-induced phlebitis in a tertiary hospital of Karachi: a cohort study

18 July 2024
Canadian Vascular Access Association
02 July 2024
Volume 33 · Issue 14

Abstract

Purpose:

This study aimed to determine the incidence of peripheral intravenous catheter (PIVC)-induced phlebitis and its predictors among adult patients hospitalized at Dow University Hospital, Karachi, Pakistan.

Methods:

A sample of 258 adult patients admitted in the selected wards and planned for peripheral intravenous catheter insertion were recruited through consecutive sampling during March to May 2019. Daily follow-ups were performed to observe signs of phlebitis using a validated tool. The cohort was followed until discharge, removal of peripheral intravenous catheter, or study conclusion.

Results:

Of 258 patients studied, 139 (53.9%) were females. A significant number of the participants 104 (40.3%) were young adults of age 20–40 years. The incidence of phlebitis was 39.1%. Tuberculosis (TB), peripheral intravenous catheter dwell time before initial assessment, administration of IV fluids, and dissatisfactory nursing care at Day 1 were associated significantly with the development of phlebitis. There was a doseresponse relationship between the catheter dwell time in hours before initial assessment and the development of phlebitis.

Conclusion:

This study found an increased incidence (39.1%) in three months of PIVC-induced phlebitis among adult patients. In addition to patient-related and PIVC-related risk factors considered in this study, PIVC-induced phlebitis is found to be significantly associated with the level of PIVC care provided by nurses. Continuous nursing education, developing standard care plans for PIVCs, and proper documentation of care are recommended.

Peripheral intravenous catheterization is the most frequently used invasive procedure and is usually performed by nurses in contemporary medical practice. Every year, more than a billion peripheral intravenous catheters (PIVCs) are used globally for hospitalized patients. However, PIVC prevalence and management data are lacking from low- and middle-income countries (LMIC) (Alexandrou et al, 2015). Three-fourths of all patients admitted to tertiary care have a vascular device in place mainly for medication therapies, fluid resuscitation, nutritional supplements, or blood and blood products transfusions (Keogh et al, 2015; Mihala et al, 2018).

Peripheral intravenous catheter insertion exposes patients to a number of early or delayed complications, minor or major based on the intensity of symptoms (Salma et al, 2019).

Among the major complications, phlebitis, caused by the inflammation of the intimal layer of the vein, is found to be the most common, leading to the removal of almost half of PIVCs (Braga et al, 2016; Suliman et al, 2020).

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Peripheral intravenous catheter
Phlebitis
Nursing care
Pakistan