title: Variability in the clinical practice of maintaining the patency of peripheral intravenous catheters.
abstract: OBJECTIVE
  To establish variations in clinical practice associated with maintaining the patency of peripheral intravenous catheters (PIC) and to determine to what extent such clinical practice falls within the limits of the available scientific evidence, based on a random sample Spanish public hospitals.
  
  
  METHODS
  A cross-sectional, descriptive study was carried out in non-psychiatric public hospitals and their associated medical and surgical units. Cluster (hospitals), stratified (hospital size), and single level (all units) sampling was applied. A questionnaire was mailed to all of the units involved.
  
  
  RESULTS
  A sample of 341 valid questionnaires was analysed (response rate 54.5%). Only one praxis-modality was carried out in the majority of units. Intermittent flushing and heparin saline versus normal saline was the most frequent modality employed, over those of continuous flushing and non-heparinised saline. There was a high degree of variation in the quantity of heparin administered: 81.7% when flushing was carried out with heparinised saline and 48.2% when it was conducted with concentrated heparin. About 40% of this variation was associated with the hospital in question, rather than with the unit. The clinical practice fell within the limits of available scientific evidence in fewer than half of the units studied.
  
  
  CONCLUSIONS
  There was a high degree of variability in the practice of maintaining PIC patency. A significant part of this variation was attributable to the hospital in which the practice was carried out. Moreover, most of this practice was carried out beyond the limits of available scientific evidence.
authors.affiliation: Department of Nursing, Universidad de Alicante, Alicante, Spain. julio.cabrero@ua.es
authors.forename: Julio
authors.initials: J
authors.lastname: Cabrero
authors.forename: M Isabel
authors.initials: MI
authors.lastname: Orts
authors.forename: M Luisa
authors.initials: ML
authors.lastname: López-Coig
authors.forename: M Luisa
authors.initials: ML
authors.lastname: Velasco
authors.forename: Miguel
authors.initials: M
authors.lastname: Richart
mesh_terms: D000704:Analysis of Variance; D002406:Catheterization, Peripheral / Q000295:instrumentation* / Q000592:standards*; D002985:Clinical Protocols; D018592:Cross-Over Studies; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006493:Heparin / Q000008:administration & dosage; D006779:Hospitals, Public; D006801:Humans; D012965:Sodium Chloride / Q000008:administration & dosage; D013030:Spain; D011795:Surveys and Questionnaires; D007507:Therapeutic Irrigation / Q000379:methods
chemical_list: D005343:Fibrinolytic Agents; D012965:Sodium Chloride; D006493:Heparin