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Peripheral intravenous catheter failure: A secondary analysis of risks from 11,830 catheters

N. Marsh, E. Larsen, Mari D. Takashima, Tricia M. Kleidon, Samantha Keogh, A. Ullman, G. Mihala, V. Chopra et al.

International Journal of Nursing Studies, 2021

8,200 participants · 130 citations

Abstract

BACKGROUND

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…

How strong is the evidence?

Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 8,200 participants or records.

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