Comparison of the Effects of Replacing Peripheral Intravenous Catheters at 96 Hours Versus 72 Hours Among Surgical Inpatients in Otorhinolaryngology Department: A Pilot Randomized Controlled Trial

Kuo, Chia-Chi

Wednesday, 24 July 2013

Chia-Chi Kuo, RN, MSN
Emergency Department, Chi-Mei Medical Center, Taiwan., Tainan, Taiwan
Wei-Na Wang, MSN
Chi Mei Hospital, Liouying No.201, Taikang, Taikang Vil., Liuying Dist., Tainan City 736, Taiwan (R.O.C.), Chi Mei Medical Center, Tainan City, Taiwan
Yu-Rung Wang, MSN, RN
Department of Nursing, Chi Mei Medical Center, Tainan City, Taiwan

Learning Objective 1: The learner could understand the effects of replacing peripheral intravenous catheters at 96 hours versus 72 hours among surgical inpatients in otorhinolaryngology department.

Learning Objective 2: The learner will acquire the information about how to transfer of evidence-based nursing into clinical practice.

Background: Peripheral intravenous catheterisation is the most common invasive procedure in clinical practice. Traditionally, these catheters are routinely replaced every three days to prevent complications. Previous studies have indicated no significant differences in phlebitis rates between 72- and 96-hour intervals.

Purpose: The study was to explore the differences of associated complications of phlebitis as well as the manpower and cost involved when replacing peripheral intravenous catheters every 96 hours versus 72 hours among surgical inpatients in an otorhinolaryngology department.

Methods: A pilot, two-group, pretest-posttest randomized controlled trial design was adopted. Using convenience sampling, surgical inpatients in the otorhinolaryngology department of a medical center in southern Taiwan were recruited. Block randomization was used to assign 30 participants to the 96-hour group and 32 participants to the 72-hour group. Their pretest-posttest differences of associated complications of phlebitis as well as the manpower and cost involved were compared.

Results: No significant pretest-posttest differences (p = 1.00) were found in phlebitis, local infections, and catheter tip culture of both groups. The rates of phlebitis and local infections were 0% in both groups; each group had one case with positive catheter tip culture. The 72-hour group had significantly higher material and manpower costs than the 96-hour group (p < .0001).

Conclusion/Implications for practice: The evidence-based results indicated no significant differences in rates of complications of phlebitis, local infections, and catheter tip culture when replacing peripheral intravenous catheters at 96 hours versus 72 hours. However, the 96-hour group significantly reduced the cost and manpower consumption. Therefore, we suggest that if no infection signs at the intravenous injection sites are detected by nurses of three shifts, the optimal peripheral intravenous catheter replacement interval is 96 hours as compared to 72 hours.

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