title: A meta-analysis of effects of heparin flush and saline flush: quality and cost implications.
abstract: The purpose of this meta-analysis was to estimate the effects of heparin flush and saline flush solutions on maintaining patency, preventing phlebitis, and increasing duration in peripheral heparin locks. The average effect size (d value) across 15 studies with a total sample size of 3,490 was .0573 for patency (clotting). The 95% credibility interval ranged from -.2267 to .3413. The average effect size across 13 studies with a total sample size of 2,356 was -.0757 for phlebitis. The 95% credibility interval ranged from -.2497 to .0983. The average effect size for duration across six samples with a total sample size of 1,960 was -.0550. The 95% credibility interval ranged from -.2424 to .1324. It can be concluded that saline is as effective as heparin in maintaining patency, preventing phlebitis, and increasing duration in peripheral intravenous locks. Quality of care can be enhanced by using saline as the flush solution, thereby eliminating problems associated with anticoagulant effects and drug incompatibilities. In addition, an estimated yearly savings of $109,100,000 to $218,200,000 U.S. health care dollars could be attained.
authors.affiliation: University of Iowa Hospitals and Clinics, Iowa City.
authors.forename: C J
authors.initials: CJ
authors.lastname: Goode
authors.forename: M
authors.initials: M
authors.lastname: Titler
authors.forename: B
authors.initials: B
authors.lastname: Rakel
authors.forename: D S
authors.initials: DS
authors.lastname: Ones
authors.forename: C
authors.initials: C
authors.lastname: Kleiber
authors.forename: S
authors.initials: S
authors.lastname: Small
authors.forename: P K
authors.initials: PK
authors.lastname: Triolo
mesh_terms: D002406:Catheterization, Peripheral / Q000451:nursing*; D002408:Catheters, Indwelling; D015400:Clinical Nursing Research; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D008283:Maintenance; D015201:Meta-Analysis as Topic; D011787:Quality of Health Care; D012307:Risk Factors; D012965:Sodium Chloride / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D013924:Thrombophlebitis / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control
chemical_list: D012965:Sodium Chloride; D006493:Heparin