Kassahun Chanyalew Worku, Abate Addisu Taye, Tezera Zewdu Baye, Beshah Debrewok Tesgera, Agegnehu Chilot Desta, Getnet Mehmmed Adem, Abate Hailemichael Kindie, Yazew Birhaneslasie Gebeyehu, Alemu Mahlet Temesgen
Department of Medical Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Surgical Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Nurs Res Pract. 2022 Jan 22;2022:8261225. doi: 10.1155/2022/8261225. eCollection 2022.
Complications of peripheral intravenous catheters cause problems in clinical practice and bring high costs in terms of morbidity and mortality of patients. Therefore, this study aimed to assess the incidence and associated factors of failed first peripheral intravenous catheters among adult patients in selected Public Referral Hospitals of West Amhara Regional State, Ethiopia, 2021.
An institution-based prospective observational study was conducted among 423 adult patients from January to February 2021. Patients were selected using systematic random sampling techniques. The data were collected using interviewer-based, structured questionnaires and observational checklists. EPI-DATA 3.1 and SPSS version-23 were used for data entry and analysis, respectively. Frequency, percentages, and means were calculated. The outcome variable was determined and graded based on phlebitis and infiltration scales. Binary and multivariable logistics regressions were computed.
Four hundred and seventeen first peripheral cannula sites from 418 patients were followed for 2,565 peripheral catheter hours. A failed first peripheral intravenous catheter was observed in 124 (29.7%, CI: 25.6-34) adult patients. Patients who were female (AOR = 0.4, 95% CI: 0.22-0.74) had cannula duration of 49-72 hours (AOR = 0.31, 95% CI: 0.14-0.7) and 73-96 hours (AOR = 0.39, 95% CI: 0.17-0.9), and patients who had been given electrolytes (AOR = 0.31, 95% CI: 0.11-0.86) were more likely to have failed first peripheral intravenous cannula.
Failed first peripheral intravenous cannula is much higher as compared to the acceptable rate of ≤5% by the Infusion Nurses Society. Hence, all patients with peripheral intravenous catheters are screened for catheter failure at least once a day. Providing appropriate nursing care and patient education is also required to reduce the risks.
外周静脉导管的并发症在临床实践中引发诸多问题，在患者的发病率和死亡率方面带来高昂成本。因此，本研究旨在评估2021年埃塞俄比亚阿姆哈拉州西部选定公立转诊医院成年患者首次外周静脉导管置管失败的发生率及相关因素。
2021年1月至2月，对423例成年患者开展了一项基于机构的前瞻性观察性研究。采用系统随机抽样技术选取患者。通过基于访谈的结构化问卷和观察清单收集数据。分别使用EPI-DATA 3.1和SPSS 23版软件进行数据录入和分析。计算频率、百分比和均值。根据静脉炎和渗漏量表确定并分级结果变量。进行二元和多变量逻辑回归分析。
对418例患者的417个首次外周插管部位进行了2565小时的外周导管监测。124例（29.7%，CI：25.6 - 34）成年患者首次外周静脉导管置管失败。女性患者（调整后比值比[AOR]=0.4，95%CI：0.22 - 0.74）、置管时长为49 - 72小时的患者（AOR = 0.31，95%CI：0.14 - 0.7）以及73 - 96小时的患者（AOR = 0.39，95%CI：0.17 - 0.9），还有接受电解质治疗的患者（AOR = 0.31，95%CI：0.11 - 0.86）首次外周静脉插管失败的可能性更高。
首次外周静脉导管置管失败率远高于输液护理学会可接受的≤5%的比率。因此，所有外周静脉置管患者至少每天筛查一次导管失败情况。还需要提供适当的护理和患者教育以降低风险。
