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dc.contributor.authorMarsh, N
dc.contributor.authorLarsen, EN
dc.contributor.authorTakashima, M
dc.contributor.authorKleidon, T
dc.contributor.authorKeogh, S
dc.contributor.authorUllman, AJ
dc.contributor.authorMihala, G
dc.contributor.authorChopra, V
dc.contributor.authorRickard, CM
dc.date.accessioned2021-11-05T04:17:11Z
dc.date.available2021-11-05T04:17:11Z
dc.date.issued2021
dc.identifier.issn0020-7489
dc.identifier.doi10.1016/j.ijnurstu.2021.104095
dc.identifier.urihttp://hdl.handle.net/10072/409860
dc.description.abstractBackground: Peripheral intravenous catheters are an essential medical device which are prone to complications and failure. Objectives: Identify patient, provider and device risk factors associated with all-cause peripheral intravenous catheter failure as well as individual complications: phlebitis, infiltration/occlusion, and dislodgement to improve patient outcomes. Design: Secondary analysis of twelve prospective studies performed between 2008 and 2020. Settings: Australian metropolitan and regional hospitals including one paediatric hospital. Participants: Participants were from medical, surgical, haematology, and oncology units. Methods: Multilevel mixed-effects parametric survival regression was used to identify factors associated with all-cause peripheral intravenous catheter failure, phlebitis, occlusion/infiltration, and dislodgement. We studied patient (e.g., age, gender), device (e.g., gauge), and provider (e.g., inserting clinician) variables. Stepwise regression involved clinically and p<0.20 significant variables entered into the multivariable model. Results were expressed as hazard ratios (HRs) and 95% confidence intervals (CI); p<0.01 was considered statistically significant. Results: Of 11,830 peripheral intravenous catheters (8,200 participants) failure occurred in 36% (n = 4,263). Occlusion/infiltration incidence was 23% (n = 2,767), phlebitis 12% (n = 1,421), and dislodgement 7% (n = 779) of catheters. Patient factors significantly associated with failure and complications were: female gender (phlebitis; (HR 1.98, 95% CI 1.72–2.27), (infiltration/occlusion; HR 1.45, 95% CI 1.33–1.58), (failure; HR 1.36, 95% CI 1.26–1.46); and each year increase in age (phlebitis; 0.99 HR, 95% CI 0.98–0.99), (failure; 0.99 HR, 95% CI 0.99–0.99). The strongest provider risk factor was intravenous antibiotics (infiltration/occlusion; HR 1.40, 95% CI 1.27–1.53), (phlebitis; HR 1.36, 95% CI 1.18–1.56), (failure; HR 1.26, 95% CI 1.17–1.36). Catheters inserted by vascular access teams were less likely to dislodge (HR 0.53, 95% CI 0.42–0.67). Device risk factors most associated with all-cause failure were wrist/hand (HR 1.34, 95% CI 1.23–1.46), antecubital fossa peripheral intravenous catheters (HR 1.29, 95% CI 1.16–1.44) and 22/24 gauge (HR 1.27, 95% CI 1.12–1.45) catheters. Conclusion: Factors identified, including the protective aspect of vascular access team insertion, and high catheter failure associated with intravenous antibiotic administration, will allow targeted updates of peripheral intravenous catheter guidelines and models of care.
dc.description.peerreviewedYes
dc.languageeng
dc.publisherElsevier BV
dc.relation.ispartofpagefrom104095
dc.relation.ispartofjournalInternational Journal of Nursing Studies
dc.relation.ispartofvolume124
dc.subject.fieldofresearchNursing
dc.subject.fieldofresearchcode4205
dc.subject.keywordsAdministration, intravenous
dc.subject.keywordsCatheterization, peripheral
dc.subject.keywordsCatheters, indwelling
dc.subject.keywordsInfusion, intravenous
dc.subject.keywordsNurse
dc.titlePeripheral intravenous catheter failure: A secondary analysis of risks from 11,830 catheters
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationMarsh, N; Larsen, EN; Takashima, M; Kleidon, T; Keogh, S; Ullman, AJ; Mihala, G; Chopra, V; Rickard, CM, Peripheral intravenous catheter failure: A secondary analysis of risks from 11,830 catheters, International Journal of Nursing Studies, 2021, 124, pp. 104095-
dcterms.dateAccepted2021-09-21
dcterms.licensehttps://creativecommons.org/licenses/by-nc-nd/4.0/
dc.date.updated2021-11-04T02:09:14Z
dc.description.versionVersion of Record (VoR)
gro.rights.copyright© 2021 The Author(s). Published by ElsevierLtd. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International (CC BY-NC-ND 4.0) License, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.
gro.hasfulltextFull Text
gro.griffith.authorLarsen, Emily N.


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