Routine care of peripheral intravenous catheters versus clinically indicated replacement: randomised controlled trial

Webster, Joan, Clarke, Samantha A., Paterson, Dana, Hutton, Anne, van Dyk, Stacey, Gale, Catherine, & Hopkins, Tracey (2008) Routine care of peripheral intravenous catheters versus clinically indicated replacement: randomised controlled trial. British Medical Journal, 337(7662), a339.

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Objective To compare routine replacement of intravenous peripheral catheters with replacement only when clinically indicated. Design Randomised controlled trial. Setting Tertiary hospital in Australia. Participants 755 medical and surgical patients: 379 allocated to catheter replacement only when clinically indicated and 376 allocated to routine care of catheter (control group). Main outcome measure A composite measure of intravenous failure resulting from phlebitis or infiltration. Results Catheters were removed because of phlebitis or infiltration from 123 of 376 (33%) patients in the control group compared with 143 of 379 (38%) patients in the intervention group; the difference was not significant (relative risk 1.15, 95% confidence interval 0.95 to 1.40). When the analysis was based on failure per 1000 device days (number of failures divided by number of days catheterised, divided by 1000), no difference could be detected between the groups (relative risk 0.98, 0.78 to 1.24). Catheter related costs were higher in the control group (mean $A41.02; £19.71; €24.80) than intervention group ($A36.40). The rate of phlebitis in both groups was low (4% in intervention group, 3% in control group). Conclusion Replacing peripheral intravenous catheters when clinically indicated has no effect the incidence of failure, based on a composite measure of phlebitis or infiltration. Larger trials are needed to test this finding using phlebitis alone as a more clinically meaningful outcome. Registration number Australian New Zealand Clinical Trials Registry ACTRN12605000147684.

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ID Code: 17337
Item Type: Journal Article
Refereed: Yes
DOI: 10.1136/bmj.a339
ISSN: 0959-8146
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
Copyright Owner: Copyright 2008 BMJ Publishing Group
Copyright Statement: First published in the British Medical Journal, 337(7662). a339. Reproduced in accordance with the copyright policy of the publisher.
Deposited On: 02 Feb 2009 23:13
Last Modified: 29 Feb 2012 13:45

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