Faktori rizika za nastanak lokalnih komplikacija periferne intravenske terapije kod hospitalizovanih bolesnika
Risk factors for the development of local complications associated with intravenous therapy in hospitalized patients
Committee membersAndrijević, Ilija
MetadataShow full item record
More than 80 percents of patients in modern hospital conditions receive some type of intravenous therapy, mostly through peripheral venous cannula (PVC). Over the past two decades, monitoring incidence rate of local complications associated with intravascular catheter, and identification of risk factors contributing to their occurrence, have been intensified in many countries. Studies show that local complications are not only matters of health but also matters of economics because not only patients and health care professionals have increased material and non-material costs but also health institutions and society as a whole. The main objectives of the present study were to determine the types and frequency of local complications associated with intravenous therapy administration through peripheral venous cannula (PVC), their association with other characteristics of the respondents and the contribution of the independent risk factors for the occurrence of these complications. The res...earch was conducted as a retrospective - prospective study in the Clinical Center of Vojvodina in Novi Sad, at the Infectious Diseases Clinics, in the period from April to September, 2012. The study included 368 patients. The patient's data were collected on the basis of taking his/her history, from medical history and hospital reports. Data on administered drugs and solutions were obtained using data from medical documentation. Data on setting up cannula were recorded on PVC hospital chart immediately after completion of the cannulation procedure. The size of the cannula was regulated by the international standards (ISO 10555-5), and the vein access quality criteria were met using standardized Vein Assessment Tool. A numeric pain rating scale was used for assessing pain intensity, and a data collection form was used for registering the PVC insertion site. Infiltration scale and Visual Infusion Phlebitis (VIP) score, respectively, were used for the diagnosis of local complications. During the present study, at least once a day, the researcher assessed the insertion site using the above mentioned visual infusion phlebitis scores and documented it in a written form. Study shows that local complications associated with peripheral intravenous therapy occurred in 80.7 percents of patients, with phlebitis rate of 44 percents, and as regards to the signs and symptoms incidence rate, the most frequent was grade III phlebitis, infiltration rate was 16.3 percents , while in comparisont o the symptomsa nd signsi ncidencei ate the most frequent was grade II infiltration. The incidence rate of local complications associated with peripheral intravenous therapy was greater in elderly patients, female patients, patients with BMI < 18.5, patients with comorbid diseases, especially diabetes, patients with severe infection, patients with history of peripheral intravenous- related complications. Mechanical risk factors which predispose local complications of peripheral intravenous therapy are: cannula material, diameter of cannula,the cannula insertion site, the number of cannula set ups in the same anatomical region, the retention time of the cannula in situ. Chemical risk factors which predispose local complications of peripheral intravenous therapy are: the number of drugs administered , and not the type of drug , the duration of drug use that poses a risk (beta-lactam antibacterial drugs drugs with pH < 5), the number of administered solutions posing a risk (osmolarity solution > 450 mOsm/l and a pH < 5), the administration of hypertonic solutions and the total time of administering infusion solutions. Given that the majority of local complications are preventable, the use of peripheral intravenous therapy must be carefully considered in relation to the identified risk factors. The protocol and the results of this study, may represent a good starting point for further investigation.