The related factors of peripheral phlebitis in neurosurgery intensive care unit
Date Issued
2014
Date
2014
Author(s)
Pan, Yu-Han
Abstract
Background: Peripheral intravenous catheter is the fastest and most common ways of administering treatments to inpatients. However, this still poses the risk of complications such as phlebitis. Although factors of phlebitis have been widely investigated, uncertainties still remain on different researches, rarely appear in intensive care unit patients. Objective: The purpose of this study was to investigate the incidence rate and related factors of phlebitis in patients in neurosurgery intensive care unit (NICU). Methods: This study used a prospective observation research design and convenience sampling. Subjects were recruited from NICU of a medical center in Taipei from February to May 2014. Structured questionnaire which including personal-related, material-related and human-related factors, combined with Infusion Nursing Society (INS) phlebitis scale and Jackson Visual Infusion Phlebitis (VIP) Score were used for data collection. Catheter insertion sites were monitored every 24hours during catheter insertion and 48hours after removal of the catheter. Data were analyzed by SPSS version 20.0. Results: A total of 98 patients and 196 insertion sites were evaluated. The findings were as follows: (1)Incidence of phlebitis was 13.3% for NICU patients; (2)Diagnosis with Intracranial Hemorrhage(ICH) (Relative risk[RR]=6.67, p<0.05), insertion site with edema (RR=2.27, p<0.05), insertion site at lower limb(RR=2.94, p<0.05) or antecubital fossa (RR=2.63, p<0.05), agitation (RR=4.20, p<0.05), physical restraint (RR=2.78, p<0.05), medicine administered 1~3types/day(RR=1.19, p<0.05) or ≥4 types/day (RR=1.21, p<0.05), using sedatives (RR=3.33, p<0.05), inotropic or hypotensive agents (RR=2.27, p<0.05), medicine administered 1~3times/day (RR=1.29, p<0.05) or ≥4times/day (RR=1.09, p<0.05), catheter inserted at Emergency Room(ER) or ward (RR=2.38, p<0.05) had significant higher risk with phlebitis; (3)On the whole, the odd ratio of patients that were diagnosed with ICH, had catheter inserted at lower limbs or the antecubital fossa, were agitated, were physical restrained, were administered four or more types of medicine per day, were using sedatives, were administrated medicine 1~3times/day, and had catheter inserted at the ER or ward was 1.19 times than that of other patients (OR=1.19, 95%CI=0.13~0.21, χ2=494.20, p<0.01). Conclusions: Phlebitis rate of this study is higher than the recommended 5%. The results of this study reveal that personal-related, material-related and human-related factors are correlated with phlebitis incidence. In addition, the INS phlebitis scale is a rigorous, valid and reliable tool for the assessment of phlebitis. The results of this study provide reference for healthcare and shed light on the factors that contribute to phlebitis in NICU patients. With timely assessments and measures, medical personnel can increase the comfort of patients, reduce medical costs, and increase healthcare quality.
Subjects
phlebitis
INS phlebitis scale
Jackson VIP score
Neurosurgery Intensive Care Unit
SDGs
Type
thesis
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