Phlebitis associated with peripheral intravenous catheters and nursing care<p>Periferik intravenöz kateterle ilişkili flebit ve hemşirelik bakımı
Keywords:
Phlebitis, Mechanical Phlebitis, Chemical Phlebitis, Bacterial Phlebitis, Nursing Care, Risk Factors, Flebit, Mekanik Flebit, Kimyasal Flebit, Bakteriyel Flebit, Hemşirelik Bakımı, Risk FaktörleriAbstract
Phlebitis, defined as inflammation of the tunica intima, is most important of complications associated with peripheral intravenous catheters and, occurs between 0.1% and 63.3% of patients with peripheral intravenous catheter. Phlebitis can be originated mechanical, chemical and, bacterial. Whatever the reason, phlebitis extends the duration of hospitalization, raise the cost of treatment, causes bacteremia. There are reported to be effective some factors such as type of catheter material, catheter size, dwell time of catheterisation, anatomical region used for catheterisation, health personnel’s ability to place the catheter, liquid flow rate, using infusion pumps, number of intravenous medication, on the development of mechanical phlebitis. Chemical phlebitis, developes due to characteristics such as pH and osmolarity of the drug and fluid infused which caused irritation of the endothelial layer through the cannula. Bacterial phlebitis, which is occured a bacterial infection of vein intima, can be a source of serious systemic infections including bacteremia. As a result, phlebitis is a complication of intravenous application, can be avoided as long as working in accordance with certain principles. The risk development of phlebitis can be minimized, in case of compliance with the standards during peripheral intravenous catheter insertion and throughout of catheterization. In this article was focused on phlebitis definition, epidemiology, risk factors and prevention of the development phlebitis for risk factors and patient care with phlebitis.
Özet
Venin tunika intima tabakasının enflamasyonu olarak tanımlanan flebit, periferik intravenöz kateterlerle ilişkili komplikasyonların en önemlisi olup, periferik intravenöz kateter takılan hastaların %0.1-%63.3’ünde görülmektedir. Flebit mekanik, kimyasal ve bakteriyel kaynaklı olabilir. Flebit nedeni ne olursa olsun hastaların yatış süresini uzatmakta, tedavi maliyetini yükseltmekte ve bakteriyemiye neden olmaktadır. Kateter materyalinin tipi, kateteterin boyutu, kateterin vende kalış süresi, kullanılan anatomik bölge, kateteri yerleştiren kişinin becerisi, sıvı akış hızı, infüzyon pompalarının kullanımı, verilen ilaçların sayısı gibi faktörlerin mekanik flebit oluşumunda etkili olduğu bildirilmektedir. Kimyasal flebit, kanül boyunca infüze edilen ilaç ve sıvıların pH’sı ve osmolaritesi gibi özelliklerinden dolayı venin endoteyal katmanını tahriş etmesi sonucunda gelişir. Ven intimasının bakteriyel enfeksiyonu sonucu gelişen bakteriyel flebit bakteriyemi gibi ciddi sistemik enfeksiyonların kaynağı olabilmektedir. Sonuç olarak, flebit belirli ilkelere uygun çalışıldığında intravenöz uygulamaların önlenebilir bir komplikasyonudur. Periferik intravenöz kateter takma ve izlem sırasında belirlenen standartlara uyulma hassasiyeti gösterildiği taktirde flebit gelişimi minimize edilebilir. Bu makalede, flebitin tanımı, epidemiyolojisi, risk faktörleri ve risk faktörlerine yönelik flebit gelişimini önleme önerileri ve flebit gelişen hastanın bakımı üzerinde odaklanılmıştır.
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Abadi, Sarani Ali, Entamadi Su, and Abed Saeedi. 2013. “Investigating Role of Mechanical and Chemical Factors in the Creation of Peripheral Vein in Flammarion in Hospitalization Patients in Hospital in Zahedan , Iran Sarani.” 10: 61–76.
Abbas, Syed Zafar, Theodorus Klass de Vries, Steve Shaw, and Syed Qamar Abbas. 2007. “Use and Complications of Peripheral Vascular Catheters: A Prospective Study.” British journal of nursing (Mark Allen Publishing) 16(11): 648, 650, 652.
Abolfotouh, Mostafa A. et al. 2014. “Prospective Study of Incidence and Predictors of Peripheral Intravenous Catheter-Induced Complications.” Therapeutics and Clinical Risk Management 10: 993.
Bispo e Silva, Adriana Serafim, and Maria Lúcia Zanetti. 2004. “[Bandage to Fix a Peripheral Intravenous Catheter: An Integrative Literature Review].” Revista brasileira de enfermagem 57(2): 233–36.
Bregenzer, T, D Conen, P Sakmann, and a F Widmer. 1998. “Is Routine Replacement of Peripheral Intravenous Catheters Necessary?” Archives of internal medicine 158(2): 151–56.
Carballo, Monserrat, Montserrat Llinas, and M Feijoo. 2004. “[Phlebitis in Peripheral Catheters (II). A Study].” Revista de enfermería (Barcelona, Spain) 27(9): 34–38.
Catney, M R et al. 2001. “Relationship between Peripheral Intravenous Catheter Dwell Time and the Development of Phlebitis and Infiltration.” Journal of infusion nursing : the official publication of the Infusion Nurses Society 24(5): 332–41.
Cicolini, Giancarlo et al. 2014. “Phlebitis Risk Varies by Peripheral Venous Catheter Site and Increases after 96??hours: A Large Multi-Centre Prospective Study.” Journal of Advanced Nursing 70(11): 2539–49.
Cicolini, Giancarlo, Antonia Pollidoro Bonghi, Luisa Di Labio, and Rocco Di Mascio. 2009. “Position of Peripheral Venous Cannulae and the Incidence of Thrombophlebitis: An Observational Study.” Journal of Advanced Nursing 65(6): 1268–73.
Cornely OA, Bethe U, Pauls R, Waldschmidt D. 2002. “Peripheral Teflon Catheters: Factors Determining Incidence Of Phlebitis And Duration Of Cannulation Oliver.” Infection control and hospital epidemiology 23(5): 249–53.
Curran, E.T et al. 2000. “Multi-Centre Research Surveillance Project to Reduce Infections/phlebitis Associated with Peripheral Vascular Catheters.” Journal of Hospital Infection 46(3): 194–202.
Dunda, S E et al. 2015. “Management, Clinical Outcomes, and Complications of Acute Cannula-Related Peripheral Vein Phlebitis of the Upper Extremity: A Retrospective Study.” Phlebology / Venous Forum of the Royal Society of Medicine 30(6): 381–88.
Dychter, Samuel S, David A Gold, Deborah Carson, and Michael Haller. “Intravenous Therapy: A Review of Complications and Economic Considerations of Peripheral Access.” Journal of infusion nursing : the official publication of the Infusion Nurses Society 35(2): 84–91.
Dychter, Samuel S., David a. Gold, Deborah Carson, and Michael Haller. 2012. “Intravenous Therapy.” Journal of Infusion Nursing 35(2): 84–91.
Fakih, Mohamad G et al. 2013. “Peripheral Venous Catheter Care in the Emergency Department: Education and Feedback Lead to Marked Improvements.” American journal of infection control 41(6): 531–36.
Ferreira, Lucilene Reno, Mavilde da Luz Gonçalves Pedreira, and Solange Diccini. 2007a. “Flebite No Pré E Pós-Operatório de Pacientes Neurocirúrgicos.” Acta Paulista de Enfermagem 20(1): 30–36.
———. 2007b. “Flebite No Pré E Pós-Operatório de Pacientes Neurocirúrgicos *.” Acta Paul Enferm 20(1): 30–36.
Forni, Cristina et al. 2010. “[Cohort Study of Peripheral Catheter Related Complications and Identification of Predictive Factors in a Population of Orthopedic Patients].” Assistenza infermieristica e ricerca: AIR 29(4): 166–73.
Gaukroger, P B, J G Roberts, and T A Manners. 1988. “Infusion Thrombophlebitis: A Prospective Comparison of 645 Vialon and Teflon Cannulae in Anaesthetic and Postoperative Use.” Anaesthesia and intensive care 16(3): 265–71.
Gillies, Donna, and Elisabeth O’Riordan. 2012. “Should Intravenous Catheters Be Replaced Routinely?” The Lancet 380(9847): 1036–38.
González López, J L et al. 2014a. “Indwell Times, Complications and Costs of Open vs Closed Safety Peripheral Intravenous Catheters: A Randomized Study.” The Journal of hospital infection 86(2): 117–26.
González López, J. L. et al. 2014b. “Indwell Times, Complications and Costs of Open vs Closed Safety Peripheral Intravenous Catheters: A Randomized Study.” Journal of Hospital Infection 86(2): 117–26.
Grau Sanz, Ma Soledad. 2008. “Management of Peripheral Intravascular Devices.” Enfermeria clinica 20(1): 68–70.
Gupta, A., Y. Mehta, R. Juneja, and N. Trehan. 2007. “The Effect of Cannula Material on the Incidence of Peripheral Venous Thrombophlebitis.” Anaesthesia 62(11): 1139–42.
Hadaway, Lynn. 2012. “Short Peripheral Intravenous Catheters and Infections.” Journal of Infusion Nursing 35(4): 230–40.
Haddad, Fady G, Chady H Waked, and Emile F Zein. 2006. “Peripheral Venous Catheter-Related Inflammation. A Randomized Prospective Trial.” Le Journal médical libanais. The Lebanese medical journal 54(3): 139–45.
Hasselberg, D, B Ivarsson, R Andersson, and B Tingstedt. 2010. “The Handling of Peripheral Venous Catheters--from Non-Compliance to Evidence-Based Needs.” Journal of Clinical Nursing 19(23-24): 3358–63.
Heinrich, Ines et al. 2013. “Prospective Pilot Study on the Incidence of Infections Caused by Peripheral Venous Catheters at a General Surgical Ward.” GMS hygiene and infection control 8(1): Doc06.
Helm, Robert E et al. 2015. “Accepted but Unacceptable: Peripheral IV Catheter Failure.” Journal of infusion nursing: the official publication of the Infusion Nurses Society 38(3): 189–203.
Higginson, Ray, and Andrew Parry. 2011. “Phlebitis: Treatment, Care and Prevention.” Nursing times 107(36): 18–21.
Ho, Ken H M, and Daphne S K Cheung. 2012. “Guidelines on Timing in Replacing Peripheral Intravenous Catheters.” Journal of Clinical Nursing 21(11-12): 1499–1506.
Idvall, Ewa, and Lena Gunningberg. 2006. “Evidence for Elective Replacement of Peripheral Intravenous Catheter to Prevent Thrombophlebitis: A Systematic Review.” Journal of Advanced Nursing 55(6): 715–22.
Infusion Nurses Society. 2011. 34 Journal of infusion nursing : the official publication of the Infusion Nurses Society Infusión Nursing Standards of Practice. http://www.vardhandboken.se/Dokument/INS_2011.pdf.
Jackson, Andrew. 2012. “Retrospective Comparative Audit of Two Peripheral IV Securement Dressings.” British Journal of Nursing (BJN) 21(2): S16–20.
Kagel, Eric M., and Ghazi M. Rayan. 2004. “Intravenous Catheter Complications in the Hand and Forearm.” The Journal of trauma 56(1): 123–27.
Karadağ, A, and S Görgülü. 2000. “Effect of Two Different Short Peripheral Catheter Materials on Phlebitis Development.” Journal of intravenous nursing: the official publication of the Intravenous Nurses Society 23(3): 158–66.
Kaur, Prabhjot, Ramesh Thakur, Sukhpal Kaur, and Ashish Bhalla. 2011. “Assessment of Risk Factors of Phlebitis amongst Intravenous Cannulated Patients.” 7(3): 106–14.
Lanbeck, Peter, Inga Odenholt, and Otto Paulsen. 2002. “Antibiotics Differ in Their Tendency to Cause Infusion Phlebitis: A Prospective Observational Study.” Scandinavian journal of infectious diseases 34(7): 512–19.
———. 2003. “Dicloxacillin: A Higher Risk than Cloxacillin for Infusion Phlebitis.” Scandinavian journal of infectious diseases 35(6-7): 397–400.
Larsson, N, K Stenberg, L E Linder, and I Curelaru. 1989. “Cannula Thrombophlebitis: A Study in Volunteers Comparing Polytetrafluoroethylene, Polyurethane, and Polyamide-Ether-Elastomer Cannulae.” Acta anaesthesiologica Scandinavica 33(3): 223–31.
Lavery, I, and P Ingram. 2006. “Prevention of Infection in Peripheral Intravenous Devices.” Nursing standard: official newspaper of the Royal College of Nursing 20(49): 49–56; quiz 57.
Lee, Wei Ling et al. 2009. “Risk Factors for Peripheral Intravenous Catheter Infection in Hospitalized Patients: A Prospective Study of 3165 Patients.” American Journal of Infection Control 37(8): 683–86.
Lee, Wei-Ling et al. 2009. “Risk Factors for Peripheral Intravenous Catheter Infection in Hospitalized Patients: A Prospective Study of 3165 Patients.” American Journal of Infection Control 37(8): 683–86.
Lee, WL et al. 2010. “Soft Tissue Infections Related to Peripheral Intravenous Catheters in Hospitalised Patients: A Case-Control Study.” The Journal of hospital infection 76(2): 124–29.
Li, Jia et al. 2014. “A Randomised, Controlled Trial Comparing the Long-Term Effects of Peripherally Inserted Central Catheter Placement in Chemotherapy Patients Using B-Mode Ultrasound with Modified Seldinger Technique versus Blind Puncture.” European journal of oncology nursing : the official journal of European Oncology Nursing Society 18(1): 94–103.
Linder, L E et al. “Material Thrombogenicity in Central Venous Catheterization: A Comparison between Soft, Antebrachial Catheters of Silicone Elastomer and Polyurethane.” JPEN. Journal of parenteral and enteral nutrition 8(4): 399–406.
Loveday, H. P. et al. 2014. “Epic3: National Evidence-Based Guidelines for Preventing Healthcare-Associated Infections in Nhs Hospitals in England.” Journal of Hospital Infection 86(S1): S1–70.
Lundgren, Anna, Lennart Jorfeldt, and Anna-Christina Ek. 1993. “The Care and Handling of Peripheral Intravenous Cannulae on 60 Surgery and Internal Medicine Patients: An Observation Study.” Journal of Advanced Nursing 18(6): 963–71.
Ma, Meiyun et al. 2015. “Complication Risks Associated with Lower versus Upper Extremity Peripherally Inserted Central Venous Catheters in Neonates with Gastroschisis.” Journal of pediatric surgery 50(4): 556–58.
Macklin, Denise. 2003. “A Painful Complication of Peripheral IV Catheterization That May Be Prevented. By Denise Macklin, BSN, RN,C, CRNI.” American Journal of Nursing 103(2): 55–60.
Madeo, M, C Martin, and A Nobbs. 1998. “A Randomized Study Comparing IV 3000 (Transparent Polyurethane Dressing) to a Dry Gauze Dressing for Peripheral Intravenous Catheter Sites.” Journal of intravenous nursing : the official publication of the Intravenous Nurses Society 20(5): 253–56.
Maki, Dennis G, and Mendley Ringer. 1991. “Risk Factors for Infusion-Related Phlebitis with Small Peripheral Venous Catheters: A Randomized Control Trial.”Annals of Internal Medicine 114(10): 845.
Malach, Tal et al. 2006. “Prospective Surveillance of Phlebitis Associated with Peripheral Intravenous Catheters.” American Journal of Infection Control 34(5): 308–12.
Marsh, Nicole, Joan Webster, Gabor Mihala, and Claire M Rickard. 2015. “Devices and Dressings to Secure Peripheral Venous Catheters to Prevent Complications.” The Cochrane database of systematic reviews 6: CD011070.
Martínez, J. A. et al. 2009. “Evaluation of Add-on Devices for the Prevention of Phlebitis and Other Complications Associated with the Use of Peripheral Catheters in Hospitalised Adults: A Randomised Controlled Study.” Journal of Hospital Infection 73(2): 135–42.
Mestre Roca, Gabriel et al. 2012. “Assessing the Influence of Risk Factors on Rates and Dynamics of Peripheral Vein Phlebitis: An Observational Cohort Study.” Medicina clínica 139(5): 185–91.
Milutinović, Dragana, Dragana Simin, and Davor Zec. 2015. “Risk Factor for Phlebitis: A Questionnaire Study of Nurses’ Perception.” Revista latino-americana de enfermagem 23(4): 677–84.
Myrianthefs, Pavlos, Maria Sifaki, Irini Samara, and George Baltopoulos. 2005. “The Epidemiology of Peripheral Vein Complications: Evaluation of the Efficiency of Differing Methods for the Maintenance of Catheter Patency and Thrombophlebitis Prevention.” Journal of Evaluation in Clinical Practice 11(1): 85–89.
Di Nisio, Marcello, Frank Peinemann, Ettore Porreca, and W S Rutjes Anne. 2014. “Treatment for Superficial Infusion Thrombophlebitis of the Upper Extremity.” Cochrane Database of Systematic Reviews (3). http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011015/abstract.
O’Grady, Naomi P et al. 2011. “Guidelines for the Prevention of Intravascular Catheter-Related Infections.” American journal of infection control 39(4): S1–34.
Palefski, S S, and G J Stoddard. 2001. “The Infusion Nurse and Patient Complication Rates of Peripheral-Short Catheters. A Prospective Evaluation.” Journal of intravenous nursing : the official publication of the Intravenous Nurses Society 24(2): 113–23.
Pasalioglu, Kadriye Burcu, and Hatice Kaya. 2014. “Catheter Indwell Time and Phlebitis Development during Peripheral Intravenous Catheter Administration.” Pakistan Journal of Medical Sciences 30(4): 725–30.
Plusa, S M et al. 1998. “Fine-Bore Cannulas for Peripheral Intravenous Nutrition: Polyurethane or Silicone?” Annals of the Royal College of Surgeons of England 80(2): 154–56.
Powell, Jessica, Karen Gahan Tarnow, and Roxanne Perucca. 2001. “The Relationship between Peripheral Intravenous Catheter Indwell Time and the Incidence of Phlebitis.” Journal of Infusion Nursing 31(1): 39–45.
Quental, B et al. 2015. “Outbreak of Bacterial Phlebitis Related to Peripheral Intravenous Catheters at a General Hospital in Brazil.” Antimicrobial Resistance and Infection Control 4(Suppl 1): P215.
Do Rego Furtado, Luís Carlos. 2011. “Incidence and Predisposing Factors of Phlebitis in a Surgery Department.” British Journal of Nursing 20(7 SUPPL.): S16–25.
Regueiro Pose, Ma Angeles et al. 2005. “[Peripheral Venous Catheters: Incidence of Phlebitis and Its Determining Factors].” Revista de enfermería (Barcelona, Spain) 28(10): 21–28.
Rickard, Claire M, Damhnat McCann, Jane Munnings, and Matthew R McGrail. 2010. “Routine Resite of Peripheral Intravenous Devices Every 3 Days Did Not Reduce Complications Compared with Clinically Indicated Resite:a Randomised Controlled Trial.” BMC Medicine 8: 53–62.
Rivas Doblado, Jesús S et al. 2004. “[How to Reduce the Incidence of Traumatic Phlebitis].” Revista de enfermería (Barcelona, Spain) 27(9): 42–46.
Saini, Ruchi, Meenakashi Agnihotri, Ashok Gupta, and Indarjit Walia. 2011. “Epidemiology of Infiltration and Phlebitis.” (1): 22–33.
Salgueiro-Oliveira, Anabela, Pedro Parreira, and Pedro Veiga. 2012. “Incidence of Phlebitis in Patients with Peripheral Intravenous Catheters: The Influence of Some Risk Factors.” Australian Journal of Advanced Nursing 30(2): 32–39.
San Martín Rodríguez, Leticia, Angeles Henríquez Azcona, and Pilar Tina Majuelo. 2002. “[Comparison of a Transparent Dressing with Gauze. Venous Blood Vessel Maintenance].” Revista de enfermería (Barcelona, Spain) 25(2): 12–16.
Singh, R, S Bhandary, and K D Pun. 2008. “Peripheral Intravenous Catheter Related Phlebitis and Its Contributing Factors among Adult Population at KU Teaching Hospital.” Kathmandu University medical journal (KUMJ) 6(24): 443–47.
Stuart, Rhonda L et al. 2013. “Peripheral Intravenous Catheter-Associated Staphylococcus Aureus Bacteraemia: More than 5 Years of Prospective Data from Two Tertiary Health Services.” The Medical Journal of Australia 198(10): 551–53.
Tagalakis, Vicky, Susan R Kahn, Michael Libman, and Mark Blostein. 2002. “The Epidemiology of Peripheral Vein Infusion Thrombophlebitis: A Critical Review.” The American Journal of Medicine 113(2): 146–51.
Trinh, T T et al. 2011. “Peripheral Venous Catheter-Related Staphylococcus Aureus Bacteremia.” Infection Control and Hospital Epidemiology 32(6): 579–83.
Uslusoy, Esin, and Samiye Mete. 2008. “Predisposing Factors to Phlebitis in Patients with Peripheral Intravenous Catheters: A Descriptive Study.” Journal of the American Academy of Nurse Practitioners 20(4): 172–80.
Vizcarra, Cora; et al. 2014. “Recommendations for Improving Safety Practices with Short Peripheral Catheters.” Journal of Infusion Nursing 37(2): 121–24.
Wallis, Marianne C et al. 2014. “Risk Factors for Peripheral Intravenous Catheter Failure: A Multivariate Analysis of Data from a Randomized Controlled Trial.” Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America 35(1): 63–68.
Washington, Georgita T., and Robin Barrett. 2012. “Peripheral Phlebitis.” Journal of Infusion Nursing 35(4): 252–58.
Webster, Joan et al. 2008. “Routine Care of Peripheral Intravenous Catheters versus Clinically Indicated Replacement: Randomised Controlled Trial.” BMJ (Clinical research ed.) 337: a339.
———. 2015. “Postinfusion Phlebitis: Incidence and Risk Factors.” Nursing research and practice 2015: 691934.
Webster, Joan, and Sonya Osborne. 2007. “Phlebitis Associated with Peripheral Intravenous Catheters.” American journal of infection control 35(4): 287; author reply 287–88.
Yoong, Wilkinson et al. 2012. “Risk Factors of Peripheral Venous Catheterization Thrombophlebitis.” 6(1): 24–30.
Zingg, Walter, and Didier Pittet. 2009. “Peripheral Venous Catheters: An under-Evaluated Problem.” International journal of antimicrobial agents 34 Suppl 4: S38–42.
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