• J. Hosp. Infect. · Mar 2016

    Nursing care as a predictor of phlebitis related to insertion of a peripheral venous cannula in emergency departments: findings from a prospective study.

    • P Barelli, A Palese, E Ambrosi, P Zambiasi, F Fabris, A Guarnier, E Allegrini, L Bazoli, P Casson, M Marin, M Padovan, M Picogna, P Taddia, D Salmaso, P Chiari, O Marognolli, F Canzan, L Saiani, and ESAMED Group.
    • Udine University, Udine, Italy. Electronic address: alvisa.palese@uniud.it.
    • J. Hosp. Infect. 2016 Mar 1; 92 (3): 280-6.

    BackgroundTo date, few studies have investigated the occurrence of phlebitis related to insertion of a peripheral venous cannula (PVC) in an emergency department (ED).AimTo describe the natural history of ED-inserted PVC site use; the occurrence and severity of PVC-related phlebitis; and associations with patient, PVC and nursing care factors.MethodsA prospective study was undertaken of 1262 patients treated as urgent cases in EDs who remained in a medical unit for at least 24h. The first PVC inserted was observed daily until its removal; phlebitis was measured using the Visual Infusion Phlebitis Scale. Data on patient, PVC, nursing care and organizational variables were collected, and a time-to-event analysis was performed.FindingsThe prevalence of PVC-related phlebitis was 31%. The cumulative incidence (78/391) was almost 20% three days after insertion, and reached >50% (231/391) five days after insertion. Being in a specialized hospital [hazard ratio (HR) 0.583, 95% confidence interval (CI) 0.366-0.928] and receiving more nursing care (HR 0.988, 95% CI 0.983-0.993) were protective against PVC-related phlebitis at all time points. Missed nursing care increased the incidence of PVC-related phlebitis by approximately 4% (HR 1.038, 95% CI 1.001-1.077).ConclusionsMissed nursing care and expertise of the nurses caring for the patient after PVC insertion affected the incidence of phlebitis; receiving more nursing care and being in a specialized hospital were associated with lower risk of PVC-related phlebitis. These are modifiable risk factors of phlebitis, suggesting areas for intervention at both hospital and unit level.Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

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