Incidence and risk factors of peripheral venous catheter-related adverse events in cardiology department of a Tunisian university hospital: A prospective observational study

Complications of peripheral venous catheters: The need to propose an alternative route of administration

Use of peripheral venous catheters (PVCs) is very common in hospitals. According to the literature, after a visit to the emergency department >75% of hospitalised patients carry a PVC, among which almost 50% are useless. In this study, the presence and complications of PVCs in an infectious diseases (ID) unit of a French tertiary-care university hospital were monitored. A total of 614 patients were prospectively included over a 6-month period. Among the 614 patients, 509 (82.9%) arrived in the ID unit with a PVC, of which 260 (51.1%) were judged unnecessary and were removed as soon as the patients were examined by the ID team. More than one-half of PVCs were removed within 24 h in the unit (308/509; 60.5%). PVCs were complicated for 65 (12.8%) of the 509 patients, with complications including extravasation, cutaneous necrosis, lymphangitis, phlebitis, tearing off the patient, superficial venous thrombosis and arthritis. We must therefore continue to search for unjustified PVC insertion. Alternatives to the intravenous administration route must be proposed, such as subcutaneous infusion or oral antibiotic therapy.

Impact of an Innovative Securement Dressing and Tourniquet in Peripheral Intravenous Catheter-Related Complications and Contamination: An Interventional Study

Reusable tourniquets and conventional securement dressings are considered risk factors for the occurrence of reported complications and catheter-related bloodstream infections. This study’s purpose is to assess the impact of single-use disposable tourniquets and advanced occlusive polyurethane dressings with reinforced cloth borders on peripheral intravenous catheter (PIVC)-related complications and contamination. A pre- and post-interventional prospective observational study was conducted in a cardiology ward of a tertiary hospital between April 2018 and February 2019. Overall, demographic and clinical data from 156 patients and PIVC-related outcomes were collected (n = 296) as well as PIVC tips for microbiological analysis (n = 90). In the pre-intervention phase (n = 118), complication rates of 62.1% were reported, while 44.1% of the PIVCs were contaminated (n = 34). In the post-intervention phase (n = 178), complication rates decreased to 57.3%, while contamination rates significantly decreased to 17.9% (p = 0.014; n = 56). Through a logistic regression, it was found that the use of innovative technologies reduces the chance of PIVC contamination by 79% (odds ratio (OR): 0.21; 95% confidence interval (CI): 0.05–0.98; p = 0.046). Meanwhile, PIVC-related complications and fluid therapy emerged as predictors for PIVC contamination. Findings suggest that the adoption of these innovative devices in nurses’ practice contributes to the significant reduction of PIVC contamination.