A Model of Phlebitis Associated with Peripheral Intravenous Catheters in Orthopedic Inpatients
Abstract
:1. Introduction
2. Methods
2.1. Design
2.2. Participants
2.3. Data Collection
2.4. Ethical Considerations
2.5. Data Analysis
3. Results
3.1. Incidence and Severity of Phlebitis Based on the Modified INS Scale
3.2. Association between Intravenous Injection-Related Factors and the Incidence of Phlebitis
3.3. Predictive Factors for PIVC-Related Phlebitis in the 95% CI Model
3.4. Effect Sizes of Predictive Factors for PIVC-Related Phlebitis in the 95% CI Model
3.5. Fit of the Prediction Model for PIVC-related Phlebitis
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Grade | Criteria | n (%) |
---|---|---|
0 | No clinical symptoms | 173 (64.1) |
0+ | Pain at site, but no clinical symptoms | 49 (18.2) |
1+ | Erythema at access site with or without pain | 29 (10.7) |
2+ | Pain at access site with erythema and/or edema | 16 (5.9) |
3+ | Pain at access site with erythema and/or edema, streak formation, palpable venous cord | 3 (1.1) |
4+ | Pain at access site with erythema and/or edema, or palpable venous cord > 1 inch, purulent drainage | 0 (0) |
Characteristics | Categories | Occurrence of Phlebitis, n (%) | χ2 | p | |||
---|---|---|---|---|---|---|---|
Total (n = 270) | Yes (n = 97) | No (n = 173) | |||||
Individual | Sex | Male | 136 (50.4) | 47 (48.5) | 89 (51.4) | 0.12 | 0.730 |
Female | 134 (49.6) | 50 (51.5) | 84 (48.6) | ||||
Age (years) | <60 | 144 (53.3) | 48 (49.5) | 96 (55.5) | 0.68 | 0.411 | |
≥60 | 126 (46.7) | 49 (50.5) | 77 (44.5) | ||||
Underlying conditions | Yes | 122 (45.2) | 46 (47.4) | 76 (43.9) | 0.18 | 0.670 | |
No | 148 (54.8) | 51 (52.6) | 97 (56.1) | ||||
Diagnostic areas | Upper limb | 98 (36.3) | 42 (43.3) | 56 (32.4) | 5.37 | 0.068 | |
Lower limb | 145 (53.7) | 43 (44.3) | 102 (59.0) | ||||
Spine | 27 (10.0) | 12 (12.4) | 15 (8.7) | ||||
Underwent surgery | Yes | 106 (39.3) | 38 (39.2) | 68 (39.3) | 0.00 | 1.000 | |
No | 164 (60.7) | 59 (60.8) | 105 (60.7) | ||||
Vein quality | Good | 141 (52.2) | 36 (37.1) | 105 (60.7) | 17.40 | <0.001 | |
Fair | 100 (37.0) | 43 (44.3) | 57 (32.9) | ||||
Poor | 29 (10.7) | 18 (18.6) | 11 (6.4) | ||||
Caregiver residence | Yes | 157 (58.1) | 54 (55.7) | 103 (59.5) | 0.24 | 0.624 | |
No | 113 (41.9) | 43 (44.3) | 70 (40.5) | ||||
Use a walking device | Yes | 72 (26.7) | 23 (23.8) | 49 (28.3) | 0.46 | 0.497 | |
No | 198 (73.3) | 74 (76.3) | 124 (71.7) | ||||
Activity level | Inactive | 130 (48.1) | 38 (39.2) | 92 (53.2) | 4.33 | 0.037 | |
Active | 140 (51.9) | 59 (60.8) | 81 (46.8) | ||||
Chemical | Fluid therapy | Yes | 229 (84.8) | 89 (91.8) | 140 (80.9) | 4.85 | 0.028 |
No | 41 (15.2) | 8 (8.2) | 33 (19.1) | ||||
Drugs mixed with fluids | Yes | 198 (73.3) | 78 (80.4) | 120 (69.4) | 3.34 | 0.068 | |
No | 72 (26.7) | 19 (19.6) | 53 (30.6) | ||||
Number of IV drugs | <3 | 180 (66.7) | 59 (60.8) | 121 (69.9) | 1.93 | 0.164 | |
≥3 | 90 (33.3) | 38 (39.2) | 52 (30.1) | ||||
Types of antibiotics | Cephalosporin | 195 (72.2) | 66 (68.0) | 129 (74.6) | 5.91 | 0.116 | |
Penicillin | 21 (7.8) | 11 (11.3) | 10 (5.8) | ||||
Others | 12 (4.4) | 7 (7.2) | 5 (2.9) | ||||
Did not use | 42 (15.6) | 13 (13.4) | 29 (16.8) | ||||
Drugs with high osmolality | Yes | 30 (11.1) | 19 (19.6) | 11 (6.4) | 9.72 | 0.002 | |
No | 240 (88.9) | 78 (80.4) | 162 (93.6) | ||||
Use of contrast medium | Yes | 37 (13.7) | 28 (28.9) | 9 (5.2) | 27.46 | <0.001 | |
No | 233 (86.3) | 69 (71.1) | 164 (94.8) | ||||
Method of infusion | Continuous | 22 (8.1) | 4 (4.1) | 18 (10.4) | 10.18 | 0.006 | |
Intermittent | 41 (15.2) | 8 (8.2) | 33 (19.1) | ||||
Continuous and intermittent | 207 (76.7) | 85 (87.6) | 122 (70.5) | ||||
Total daily dose (mL) | <1000 | 172 (63.7) | 57 (58.8) | 115 (66.5) | 1.28 | 0.257 | |
≥1000 | 98 (36.3) | 40 (41.2) | 58 (33.5) | ||||
Mechanical | Catheter dwell time (h) | ≤24 | 48 (17.8) | 22 (22.7) | 26 (15.0) | 16.84 | 0.001 |
25–48 | 122 (45.2) | 54 (55.7) | 68 (39.3) | ||||
49–72 | 63 (23.3) | 16 (16.5) | 47 (27.2) | ||||
73–96 | 37 (13.7) | 5 (5.2) | 32 (18.5) | ||||
Side of catheter insertion | Right | 129 (47.8) | 47 (48.5) | 82 (47.4) | 0.00 | 0.968 | |
Left | 141 (52.2) | 50 (51.5) | 91 (52.6) | ||||
Site of catheter insertion | Hand | 52 (19.3) | 24 (24.7) | 28 (16.2) | 3.20 | 0.202 | |
Arm | 211 (78.1) | 70 (72.2) | 141 (81.5) | ||||
Lower limb | 7 (2.6) | 3 (3.1) | 4 (2.3) | ||||
Catheter gauge | 18 | 123 (45.6) | 48 (49.5) | 75 (43.4) | 0.71 | 0.399 | |
≤20 | 147 (54.4) | 49 (50.5) | 98 (56.6) | ||||
Infectious | Hand hygiene duration (s) | <10 | 98 (36.3) | 64 (66.0) | 34 (19.7) | 60.02 | <0.001 |
≥10 to <20 | 92 (34.1) | 32 (33.0) | 60 (34.7) | ||||
≥20 to <30 | 71 (26.3) | 1 (1.0) | 70 (40.5) | ||||
≥30 | 9 (3.3) | 0 (0.0) | 9 (5.2) | ||||
Period of nursing clinical experience (years) | <1 year | 44 (16.3) | 18 (18.6) | 26 (15.0) | 24.66 | <0.001 | |
≥1 to <3 | 74 (27.4) | 42 (43.3) | 32 (18.5) | ||||
≥3 to <5 | 31 (11.5) | 5 (5.2) | 26 (15.0) | ||||
≥5 to <7 | 96 (35.6) | 24 (24.7) | 72 (41.6) | ||||
≥7 | 25 (9.3) | 8 (8.2) | 17 (9.8) |
Factors | Variables | Category | Reference Category | Coefficient | 95% CI | Post. Prob | MCSE | ESS | |||
---|---|---|---|---|---|---|---|---|---|---|---|
Mean | Median | SD | 2.5% | 97.5% | |||||||
Individual | Vein quality | Fair | Good | 0.922 | 0.926 | 0.416 | 0.095 | 1.728 | 0.95 | 2.94−3 | 100.0 |
Poor | 2.114 | 2.098 | 0.646 | 0.880 | 3.420 | 0.95 | 4.57−3 | 99.8 | |||
Chemical | Use of contrast medium | No | Yes | −2.591 | −2.566 | 0.659 | −3.958 | −1.366 | 0.95 | 4.81−3 | 93.9 |
Infectious | Hand hygiene (s) | ≥10 to <20 | <10 | −1.595 | −1.590 | 0.404 | −2.413 | −0.828 | 0.95 | 2.86−3 | 100.0 |
≥20 to <30 | −5.549 | −5.407 | 1.205 | −8.363 | −3.617 | 0.95 | 1.02−2 | 69.8 | |||
≥30 | −26.158 | v10.335 | 46.000 | −168.176 | −2.738 | 0.95 | 2.93 | 1.2 | |||
Period of nursing clinical experience (years) _cons | ≥1 to <3 | <1 | 0.210 | 0.138 | 0.421 | −0.557 | 1.156 | NA | 3.05−3 | 95.6 | |
≥3 to <5 | −1.989 | −1.965 | 0.739 | −3.480 | −0.561 | 0.95 | 5.43−3 | 92.8 | |||
≥5 to <7 | −0.775 | −0.772 | 0.495 | −1.753 | 0.079 | NA | 3.57−3 | 96.5 | |||
≥7 | 0.715 | 0.627 | 0.704 | −0.399 | 2.246 | NA | 5.04−3 | 97.7 | |||
2.837 | 2.821 | 0.766 | 1.395 | 4.377 | NA | NA | NA |
Factors | Variables | Category | Reference Category | OR | 95% CI | Post. Prob | |||
---|---|---|---|---|---|---|---|---|---|
Mean | Median | SD | |||||||
Individual | Vein quality | Fair | Good | 2.514 | 2.525 | 1.155 | 1.100 | 5.630 | 0.95 |
Poor | 8.286 | 8.150 | 7.186 | 2.413 | 30.585 | 0.95 | |||
Chemical | Use of contrast medium | No | Yes | 0.074 | 0.076 | 0.060 | 0.019 | 0.255 | 0.95 |
Infectious | Hand hygiene (s) | ≥10 to <20 | <10 | 0.202 | 0.203 | 0.088 | 0.089 | 0.436 | 0.95 |
≥20 to <30 | 0.003 | 0.004 | 0.006 | 0.000 | 0.026 | 0.95 | |||
period of nursing clinical experience (years) _cons | ≥3 to <5 | <1 | 0.136 | 0.140 | 0.137 | 0.030 | 0.570 | 0.95 | |
17.074 | 16.809 | 19.291 | 4.035 | 79.657 | NA |
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Lee, S.; Kim, K.; Kim, J.-S. A Model of Phlebitis Associated with Peripheral Intravenous Catheters in Orthopedic Inpatients. Int. J. Environ. Res. Public Health 2019, 16, 3412. https://doi.org/10.3390/ijerph16183412
Lee S, Kim K, Kim J-S. A Model of Phlebitis Associated with Peripheral Intravenous Catheters in Orthopedic Inpatients. International Journal of Environmental Research and Public Health. 2019; 16(18):3412. https://doi.org/10.3390/ijerph16183412
Chicago/Turabian StyleLee, Sookhee, Kyunghee Kim, and Ji-Su Kim. 2019. "A Model of Phlebitis Associated with Peripheral Intravenous Catheters in Orthopedic Inpatients" International Journal of Environmental Research and Public Health 16, no. 18: 3412. https://doi.org/10.3390/ijerph16183412
APA StyleLee, S., Kim, K., & Kim, J. -S. (2019). A Model of Phlebitis Associated with Peripheral Intravenous Catheters in Orthopedic Inpatients. International Journal of Environmental Research and Public Health, 16(18), 3412. https://doi.org/10.3390/ijerph16183412