Journal article
Routine replacement versus replacement as clinical indicated of peripheral intravenous catheters: A multisite randomised controlled trial
Journal of Clinical Nursing, Vol.31(19-20), pp.2959-2970
2022
PMID: 34779070
Abstract
Aims and objectives:
To compare the safety of replacing peripheral intravenous catheter as clinically indicated versus routine replacement on patient outcomes in the Chinese context.
Background:
Some evidence from developed countries recommend replacing peripheral intravenous catheter as clinically indicated; however, there is limited evidence from developing countries.
Design:
A multisite randomised controlled trial.
Methods:
The 3050 participants from three hospitals in China were randomly assigned to clinically indicated or routine replacement groups. Patients in the clinically indicated group had the catheters kept in situ until any of the following clinical signs appeared: phlebitis, infiltration, occlusion, displacement, local infection and diagnosed catheter-related bloodstream infection. Patients in the routine replacement group had their peripheral intravenous catheters replaced every 96 hours. The outcomes of phlebitis, infiltration, occlusion, displacement; catheter-related bloodstream infection, all-cause bloodstream infection, and local infection were compared. CONSORT checklist was used to guide the reporting of this RCT.
Results:
The risk of phlebitis, phlebitis per 1000 catheter days, occlusion, dislodgement, all bloodstream infections, local infection and mortality between the two groups were not significantly different. The risk of infiltration was increased in the clinically indicated group (HR 1.29). There was no catheter-related bloodstream infection reported in either group. Patients’ first peripheral intravenous catheter dwelling time and cumulative indwelling time of all peripheral intravenous catheters in the clinically indicated group were significantly longer than the routine replacement group. There was no statistical significant difference in survival times from phlebitis between the two groups.
Conclusions:
In the Chinese context, removing peripheral catheters as clinical indicated did not increase the risk of phlebitis, occlusion, catheter displacement and catheter infection; however, there was an increased infiltration incidence.
Details
- Title
- Routine replacement versus replacement as clinical indicated of peripheral intravenous catheters: A multisite randomised controlled trial
- Authors
- Jing Li (Corresponding Author) - Peking University First HospitalYanming Ding (Corresponding Author) - Peking University First HospitalQian Lu (Author) - Peking UniversitySanli Jin (Author) - Peking UniversityPeiying Zhang (Author) - Peking University First HospitalZhixia Jiang (Author) - Affiliated Hospital of Zunyi Medical CollegeFengxia Zhang (Author) - Miyun Hospital Beijing ChinaYang Lyu (Author) - Beijing Chao-Yang HospitalFrances Lin (Corresponding Author) - University of the Sunshine Coast, Queensland, School of Nursing, Midwifery and Paramedicine - Legacy
- Publication details
- Journal of Clinical Nursing, Vol.31(19-20), pp.2959-2970
- Publisher
- Wiley-Blackwell Publishing Ltd.
- DOI
- 10.1111/jocn.16129
- ISSN
- 1365-2702
- PMID
- 34779070
- Grant note
- This research was funded by the Nursing Research Fund of Peking University Health Science Center. (BMU20160519)
- Organisation Unit
- School of Nursing, Midwifery and Paramedicine - Legacy; University of the Sunshine Coast, Queensland; School of Health - Nursing
- Language
- English
- Record Identifier
- 99586006902621
- Output Type
- Journal article
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- Nursing
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