Risk Factors for Peripheral Intravenous Catheter Failure: A Multivariate Analysis of Data from a Randomized Controlled Trial
Objective. To assess the relative importance of independent risk factors for peripheral intravenous catheter (PIVC) failure. Methods. Secondary data analysis from a randomized controlled trial of PIVC dwell time. The Prentice, Williams, and Peterson statistical model was used to identify and compare...
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| creator | Wallis, Marianne C. McGrail, Matthew Webster, Joan Marsh, Nicole Gowardman, John Playford, E. Geoffrey Rickard, Claire M. |
| description | Objective. To assess the relative importance of independent risk factors for peripheral intravenous catheter (PIVC) failure.
Methods. Secondary data analysis from a randomized controlled trial of PIVC dwell time. The Prentice, Williams, and Peterson statistical model was used to identify and compare risk factors for phlebitis, occlusion, and accidental removal.
Setting. Three acute care hospitals in Queensland, Australia.
Participants. The trial included 3,283 adult medical and surgical patients (5,907 catheters) with a PIVC with greater than 4 days of expected use.
Results. Modifiable risk factors for occlusion included hand, antecubital fossa, or upper arm insertion compared with forearm (hazard ratio [HR], 1.47 [95% confidence interval (CI), 1.28–1.68], 1.27 [95% CI, 1.08–1.49], and 1.25 [95% CI, 1.04–1.50], respectively); and for phlebitis, larger diameter PIVC (HR, 1.48 [95% CI, 1.08–2.03]). PIVCs inserted by the operating and radiology suite staff had lower occlusion risk than ward insertions (HR, 0.80 [95% CI, 0.67–0.94]). Modifiable risks for accidental removal included hand or antecubital fossa insertion compared with forearm (HR, 2.45 [95% CI, 1.93–3.10] and 1.65 [95% CI, 1.23–2.22], respectively), clinical staff insertion compared with intravenous service (HR, 1.69 [95% CI, 1.30–2.20]); and smaller PIVC diameter (HR, 1.29 [95% CI, 1.02–1.61]). Female sex was a nonmodifiable factor associated with an increased risk of both phlebitis (HR, 1.64 [95% CI, 1.28–2.09]) and occlusion (HR, 1.44 [95% CI, 1.30–1.61]).
Conclusions. PIVC survival is improved by preferential forearm insertion, selection of appropriate PIVC diameter, and insertion by intravenous teams and other specialists.
Trial registration. The original randomized controlled trial on which this secondary analysis is based is registered with the Australian New Zealand Clinical Trials Registry (http://www.anzctr.org.au; ACTRN12608000445370). |
| doi_str_mv | 10.1086/674398 |
| format | Article |
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Methods. Secondary data analysis from a randomized controlled trial of PIVC dwell time. The Prentice, Williams, and Peterson statistical model was used to identify and compare risk factors for phlebitis, occlusion, and accidental removal.
Setting. Three acute care hospitals in Queensland, Australia.
Participants. The trial included 3,283 adult medical and surgical patients (5,907 catheters) with a PIVC with greater than 4 days of expected use.
Results. Modifiable risk factors for occlusion included hand, antecubital fossa, or upper arm insertion compared with forearm (hazard ratio [HR], 1.47 [95% confidence interval (CI), 1.28–1.68], 1.27 [95% CI, 1.08–1.49], and 1.25 [95% CI, 1.04–1.50], respectively); and for phlebitis, larger diameter PIVC (HR, 1.48 [95% CI, 1.08–2.03]). PIVCs inserted by the operating and radiology suite staff had lower occlusion risk than ward insertions (HR, 0.80 [95% CI, 0.67–0.94]). Modifiable risks for accidental removal included hand or antecubital fossa insertion compared with forearm (HR, 2.45 [95% CI, 1.93–3.10] and 1.65 [95% CI, 1.23–2.22], respectively), clinical staff insertion compared with intravenous service (HR, 1.69 [95% CI, 1.30–2.20]); and smaller PIVC diameter (HR, 1.29 [95% CI, 1.02–1.61]). Female sex was a nonmodifiable factor associated with an increased risk of both phlebitis (HR, 1.64 [95% CI, 1.28–2.09]) and occlusion (HR, 1.44 [95% CI, 1.30–1.61]).
Conclusions. PIVC survival is improved by preferential forearm insertion, selection of appropriate PIVC diameter, and insertion by intravenous teams and other specialists.
Trial registration. The original randomized controlled trial on which this secondary analysis is based is registered with the Australian New Zealand Clinical Trials Registry (http://www.anzctr.org.au; ACTRN12608000445370).</description><identifier>ISSN: 0899-823X</identifier><identifier>EISSN: 1559-6834</identifier><identifier>DOI: 10.1086/674398</identifier><identifier>PMID: 24334800</identifier><language>eng</language><publisher>Chicago, IL: University of Chicago Press</publisher><subject>Anti-Bacterial Agents - administration & dosage ; Antibiotics ; Antipyretics ; Antipyretics - administration & dosage ; Arm ; Biological and medical sciences ; Catheterization, Peripheral - instrumentation ; Catheterization, Peripheral - methods ; Catheters ; Catheters, Indwelling - adverse effects ; Device Removal ; Equipment Failure ; Equipment Failure Analysis ; Female ; Forearm ; Hand ; Health outcomes ; Hospital admissions ; Humans ; Infections ; Male ; Medical sciences ; Medications ; Middle Aged ; Miscellaneous ; Multivariate Analysis ; Nursing ; Operating Rooms ; Original Article ; Phlebitis ; Phlebitis - etiology ; Predisposing factors ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Radiology Department, Hospital ; Risk Factors ; Sex Factors</subject><ispartof>Infection control and hospital epidemiology, 2014-01, Vol.35 (1), p.63-68</ispartof><rights>2013 by The Society for Healthcare Epidemiology of America. All rights reserved.</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c435t-43956dba69bbec708c735fb07416664fc8d889a4572438abd330349e318cbf413</citedby><cites>FETCH-LOGICAL-c435t-43956dba69bbec708c735fb07416664fc8d889a4572438abd330349e318cbf413</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4021,27921,27922,27923</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28319524$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24334800$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wallis, Marianne C.</creatorcontrib><creatorcontrib>McGrail, Matthew</creatorcontrib><creatorcontrib>Webster, Joan</creatorcontrib><creatorcontrib>Marsh, Nicole</creatorcontrib><creatorcontrib>Gowardman, John</creatorcontrib><creatorcontrib>Playford, E. Geoffrey</creatorcontrib><creatorcontrib>Rickard, Claire M.</creatorcontrib><title>Risk Factors for Peripheral Intravenous Catheter Failure: A Multivariate Analysis of Data from a Randomized Controlled Trial</title><title>Infection control and hospital epidemiology</title><addtitle>Infect Control Hosp Epidemiol</addtitle><description>Objective. To assess the relative importance of independent risk factors for peripheral intravenous catheter (PIVC) failure.
Methods. Secondary data analysis from a randomized controlled trial of PIVC dwell time. The Prentice, Williams, and Peterson statistical model was used to identify and compare risk factors for phlebitis, occlusion, and accidental removal.
Setting. Three acute care hospitals in Queensland, Australia.
Participants. The trial included 3,283 adult medical and surgical patients (5,907 catheters) with a PIVC with greater than 4 days of expected use.
Results. Modifiable risk factors for occlusion included hand, antecubital fossa, or upper arm insertion compared with forearm (hazard ratio [HR], 1.47 [95% confidence interval (CI), 1.28–1.68], 1.27 [95% CI, 1.08–1.49], and 1.25 [95% CI, 1.04–1.50], respectively); and for phlebitis, larger diameter PIVC (HR, 1.48 [95% CI, 1.08–2.03]). PIVCs inserted by the operating and radiology suite staff had lower occlusion risk than ward insertions (HR, 0.80 [95% CI, 0.67–0.94]). Modifiable risks for accidental removal included hand or antecubital fossa insertion compared with forearm (HR, 2.45 [95% CI, 1.93–3.10] and 1.65 [95% CI, 1.23–2.22], respectively), clinical staff insertion compared with intravenous service (HR, 1.69 [95% CI, 1.30–2.20]); and smaller PIVC diameter (HR, 1.29 [95% CI, 1.02–1.61]). Female sex was a nonmodifiable factor associated with an increased risk of both phlebitis (HR, 1.64 [95% CI, 1.28–2.09]) and occlusion (HR, 1.44 [95% CI, 1.30–1.61]).
Conclusions. PIVC survival is improved by preferential forearm insertion, selection of appropriate PIVC diameter, and insertion by intravenous teams and other specialists.
Trial registration. The original randomized controlled trial on which this secondary analysis is based is registered with the Australian New Zealand Clinical Trials Registry (http://www.anzctr.org.au; ACTRN12608000445370).</description><subject>Anti-Bacterial Agents - administration & dosage</subject><subject>Antibiotics</subject><subject>Antipyretics</subject><subject>Antipyretics - administration & dosage</subject><subject>Arm</subject><subject>Biological and medical sciences</subject><subject>Catheterization, Peripheral - instrumentation</subject><subject>Catheterization, Peripheral - methods</subject><subject>Catheters</subject><subject>Catheters, Indwelling - adverse effects</subject><subject>Device Removal</subject><subject>Equipment Failure</subject><subject>Equipment Failure Analysis</subject><subject>Female</subject><subject>Forearm</subject><subject>Hand</subject><subject>Health outcomes</subject><subject>Hospital admissions</subject><subject>Humans</subject><subject>Infections</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medications</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Multivariate Analysis</subject><subject>Nursing</subject><subject>Operating Rooms</subject><subject>Original Article</subject><subject>Phlebitis</subject><subject>Phlebitis - etiology</subject><subject>Predisposing factors</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Radiology Department, Hospital</subject><subject>Risk Factors</subject><subject>Sex Factors</subject><issn>0899-823X</issn><issn>1559-6834</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10U9PHCEYBnDS1Oi61Y9gSJo2vUwLwjDQ22brv8SmxmjS2-QdBiLKDCswJho_fGl21ZMnOPzeh7wPCO1T8p0SKX6IhjMlP6AZrWtVCcn4RzQjUqlKHrK_O2g3pVtCSKMU3UY7h5wxLgmZoedLl-7wMegcYsI2RHxholvdmAgen405woMZw5TwEvKNySYW6_wUzU-8wL8nn90DRAfZ4MUI_jG5hIPFvyADtjEMGPAljH0Y3JPp8TKUwOB9uV6VIf8JbVnwyextzjm6Pj66Wp5W539OzpaL80pzVueqbFaLvgOhus7ohkjdsNp2pOFUCMGtlr2UCnjdlL0kdD1jhHFlGJW6s5yyOfq2zl3FcD-ZlNvBJW28h9GU3VrKm6YWnEpR6Nc11TGkFI1tV9ENEB9bStr_Tbfrpgs82GRO3WD6V_ZSbQFfNgCSBm8jjNqlNycZVXXRc_R57W5T-YP3nvsHr7qQPA</recordid><startdate>20140101</startdate><enddate>20140101</enddate><creator>Wallis, Marianne C.</creator><creator>McGrail, Matthew</creator><creator>Webster, Joan</creator><creator>Marsh, Nicole</creator><creator>Gowardman, John</creator><creator>Playford, E. Geoffrey</creator><creator>Rickard, Claire M.</creator><general>University of Chicago Press</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20140101</creationdate><title>Risk Factors for Peripheral Intravenous Catheter Failure: A Multivariate Analysis of Data from a Randomized Controlled Trial</title><author>Wallis, Marianne C. ; McGrail, Matthew ; Webster, Joan ; Marsh, Nicole ; Gowardman, John ; Playford, E. Geoffrey ; Rickard, Claire M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c435t-43956dba69bbec708c735fb07416664fc8d889a4572438abd330349e318cbf413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Anti-Bacterial Agents - administration & dosage</topic><topic>Antibiotics</topic><topic>Antipyretics</topic><topic>Antipyretics - administration & dosage</topic><topic>Arm</topic><topic>Biological and medical sciences</topic><topic>Catheterization, Peripheral - instrumentation</topic><topic>Catheterization, Peripheral - methods</topic><topic>Catheters</topic><topic>Catheters, Indwelling - adverse effects</topic><topic>Device Removal</topic><topic>Equipment Failure</topic><topic>Equipment Failure Analysis</topic><topic>Female</topic><topic>Forearm</topic><topic>Hand</topic><topic>Health outcomes</topic><topic>Hospital admissions</topic><topic>Humans</topic><topic>Infections</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medications</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Multivariate Analysis</topic><topic>Nursing</topic><topic>Operating Rooms</topic><topic>Original Article</topic><topic>Phlebitis</topic><topic>Phlebitis - etiology</topic><topic>Predisposing factors</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Radiology Department, Hospital</topic><topic>Risk Factors</topic><topic>Sex Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wallis, Marianne C.</creatorcontrib><creatorcontrib>McGrail, Matthew</creatorcontrib><creatorcontrib>Webster, Joan</creatorcontrib><creatorcontrib>Marsh, Nicole</creatorcontrib><creatorcontrib>Gowardman, John</creatorcontrib><creatorcontrib>Playford, E. Geoffrey</creatorcontrib><creatorcontrib>Rickard, Claire M.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Infection control and hospital epidemiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wallis, Marianne C.</au><au>McGrail, Matthew</au><au>Webster, Joan</au><au>Marsh, Nicole</au><au>Gowardman, John</au><au>Playford, E. Geoffrey</au><au>Rickard, Claire M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk Factors for Peripheral Intravenous Catheter Failure: A Multivariate Analysis of Data from a Randomized Controlled Trial</atitle><jtitle>Infection control and hospital epidemiology</jtitle><addtitle>Infect Control Hosp Epidemiol</addtitle><date>2014-01-01</date><risdate>2014</risdate><volume>35</volume><issue>1</issue><spage>63</spage><epage>68</epage><pages>63-68</pages><issn>0899-823X</issn><eissn>1559-6834</eissn><abstract>Objective. To assess the relative importance of independent risk factors for peripheral intravenous catheter (PIVC) failure.
Methods. Secondary data analysis from a randomized controlled trial of PIVC dwell time. The Prentice, Williams, and Peterson statistical model was used to identify and compare risk factors for phlebitis, occlusion, and accidental removal.
Setting. Three acute care hospitals in Queensland, Australia.
Participants. The trial included 3,283 adult medical and surgical patients (5,907 catheters) with a PIVC with greater than 4 days of expected use.
Results. Modifiable risk factors for occlusion included hand, antecubital fossa, or upper arm insertion compared with forearm (hazard ratio [HR], 1.47 [95% confidence interval (CI), 1.28–1.68], 1.27 [95% CI, 1.08–1.49], and 1.25 [95% CI, 1.04–1.50], respectively); and for phlebitis, larger diameter PIVC (HR, 1.48 [95% CI, 1.08–2.03]). PIVCs inserted by the operating and radiology suite staff had lower occlusion risk than ward insertions (HR, 0.80 [95% CI, 0.67–0.94]). Modifiable risks for accidental removal included hand or antecubital fossa insertion compared with forearm (HR, 2.45 [95% CI, 1.93–3.10] and 1.65 [95% CI, 1.23–2.22], respectively), clinical staff insertion compared with intravenous service (HR, 1.69 [95% CI, 1.30–2.20]); and smaller PIVC diameter (HR, 1.29 [95% CI, 1.02–1.61]). Female sex was a nonmodifiable factor associated with an increased risk of both phlebitis (HR, 1.64 [95% CI, 1.28–2.09]) and occlusion (HR, 1.44 [95% CI, 1.30–1.61]).
Conclusions. PIVC survival is improved by preferential forearm insertion, selection of appropriate PIVC diameter, and insertion by intravenous teams and other specialists.
Trial registration. The original randomized controlled trial on which this secondary analysis is based is registered with the Australian New Zealand Clinical Trials Registry (http://www.anzctr.org.au; ACTRN12608000445370).</abstract><cop>Chicago, IL</cop><pub>University of Chicago Press</pub><pmid>24334800</pmid><doi>10.1086/674398</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Infection control and hospital epidemiology, 2014-01, Vol.35 (1), p.63-68 |
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| source | Cambridge Journals Online; MEDLINE |
| subjects | Anti-Bacterial Agents - administration & dosage Antibiotics Antipyretics Antipyretics - administration & dosage Arm Biological and medical sciences Catheterization, Peripheral - instrumentation Catheterization, Peripheral - methods Catheters Catheters, Indwelling - adverse effects Device Removal Equipment Failure Equipment Failure Analysis Female Forearm Hand Health outcomes Hospital admissions Humans Infections Male Medical sciences Medications Middle Aged Miscellaneous Multivariate Analysis Nursing Operating Rooms Original Article Phlebitis Phlebitis - etiology Predisposing factors Public health. Hygiene Public health. Hygiene-occupational medicine Radiology Department, Hospital Risk Factors Sex Factors |
| title | Risk Factors for Peripheral Intravenous Catheter Failure: A Multivariate Analysis of Data from a Randomized Controlled Trial |
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