1.Risk factors of peripheral venous catheterization thrombophlebitis
Wilkinson Yoong Jian Tan ; Jo Wearn Yeap ; Sharifah Sulaiha Syed Aznal
International e-Journal of Science, Medicine and Education 2012;6(1):24-30
Background: Peripheral venous catheterisation
is indispensable in modern practise of medicine.
The indications of venous access should be weighed
against the risk of complications, the commonest being
thrombophlebitis. Thrombophlebitis causes patient
discomfort and the need for new catheter insertion and
risk of developing further widespread infections.
Methodology: This observational study was conducted
on adult patients admitted to the surgical and medical
ward of a tertiary hospital in Negeri Sembilan Malaysia
in 2011. Four researchers visited patients daily and
examined for signs of thrombophlebitis; warmth,
erythema, swelling, tenderness or a palpable venous
cord. Risks factors that were studied in this research
were patient/s age and gender, duration of catheterization,
use of catheter for infusion, size of catheter, site of
catheter insertion and types of infusate. Thrombophlebitis
was graded using a scale adapted from Bhandari et al.
(1979).
Results: In total, 428 patients were recruited with
an incidence rate of thrombophlebitis of 35.2%.
Among those who developed thrombophlebitis, 65%
had mild thrombophlebitis, 19% moderate and 8%
severe thrombophlebitis. Results showed that female
patients had a significant increased risk of developing
thrombophlebitis. Also risk increased significantly with
increased duration of catheterization and usage of the
catheter for infusion. The age of a patient, types of
infusate use, size of catheter and site of catheter insertion
did not significantly influence the development of
thrombophlebitis.
Conclusion: The study showed that risk of developing
thrombophlebitis is significantly increased among
female patients, and also with increased duration of
catheterization and use of the peripheral venous catheter
for infusion. We recommended elective replacement
of catheter every 72 hours and daily examination of
catheters for signs of thrombophlebitis by a healthcare
personnel.