Authors (including presenting author) :
Tam CO(1), Chan LM(1), Chui SK(1), Tang ST(1), Yip KY(1), Ho HS (1), Lam YFD (1), Lo BYE(1)
Affiliation :
(1) Department of Medicine, Pamela Youde Nethersole Eastern Hospital
Introduction :
Currently it is essential to change Intravenous Venous (IV) site at least every 4 days to minimize the chance of phlebitis. Replacement of IV site may be done without any signs of phlebitis whereas there was no clear instruction for IV cannula life span. As evidence showed no statistically significant difference in change drip site routinely and clinical indication, changing drip site routinely may not be necessary. This study would explore changing of peripheral IV catheter site by clinical indication better than routine in terms of phlebitis rate in adult patients.
Objectives :
To evaluate an evidence-based practice on changing IV cannula based on clinical indication in 4 acute medical wards
Methodology :
The study was conducted in Department of Medicine of PYNEH from 30 September – 13 October 2019. Patients who aged ≥ 18 with catheter newly setup within 24 hours and expected to receive intravenous therapy within 24 hours were recruited as interventional group (IG). The Visual Infusion Phlebitis (VIP) score was adopted to identify phlebitis occurrence. A Nursing Prescription (NP) was newly designed to facilitate the use of VIP score and to record the drip site condition. Orientation of using the NP to nursing staff was carried out for standardization. Control Group (CG) would continue to change IV cannula routinely in every 4 days and when clinically indicated, whereas IG would change IV cannula when clinically indicated. SPSS and Staff satisfactory survey were used for evaluation.
Result & Outcome :
A total of 119 patients were recruited including 82 and 37 from as IG and CG respectively. In interventional group, 9 of the drip sites were removed due to clinically indication. Also, the longest duration drip site could keep up to 23 days without phlebitis. There was no statistically significant differences in the incidence of phlebitis between changing drip site routinely and clinically indicated (p=0.719), age (p=0.225), site duration (p=0.11) and site location (p=0.955). Over 90 % Staff was satisfied with using VIP score for clinical assessment and over 80% staff recommended changing drip site by clinical indication. Routine changing peripheral IV catheter site is not necessary. The clinical indicated replacement is recommended. Clinically indicated re-site would achieve savings in equipment, staff time and patient discomfort.
