Prospective surveillance of phlebitis associated with peripheral intravenous catheters.
BACKGROUND
Guidelines have been published for prevention of phlebitis associated with peripheral intravenous catheters (IVC), but this complication continues to occur. We sought to determine the rate of phlebitis associated with peripheral IVCs to identify predictors for phlebitis and to isolate pathogenic bacteria from phlebitic catheter tips.


METHODS
Nine-point prevalence studies were conducted during the years 1996-2003 of all hospitalized patients with a peripheral IVC. During the last 3 surveys, conducted in 2003, phlebitic lines were removed, and, for each line, 1 to 2 nonphlebitic lines, in place for 48 to 72 hours, were removed and cultured as controls. In between these surveys, findings and guidelines for improvement were distributed to the staff.


RESULTS
During these surveys, 40% +/- 8% of hospitalized patients had a peripheral IVC. The rate of peripheral IVC-associated phlebitis decreased from 12.7% (20/157) in 1998 to 2.6% (5/189) in 2003 (P < .01). Factors significantly associated with phlebitis included pain (P < .001), presence of the catheter for longer than 3 days (P < .05), and cleanliness of the dressing (P < .01).


CONCLUSIONS
The rate of phlebitis associated with peripheral intravenous catheters decreased significantly throughout the study period. The identification of predictors for phlebitis and the dissemination of this information in an educational drive may have contributed to this improvement.
Malach
Tal
T
Infectious Disease Unit, Shaare Zedek Medical Center, Jerusalem, Israel.
Jerassy
Ziona
Z
Rudensky
Bernard
B
Schlesinger
Yechiel
Y
Broide
Etty
E
Olsha
Oded
O
Yinnon
Amos M
AM
Raveh
David
D
D000328:Adult; D000368:Aged; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D003428:Cross Infection / Q000209:etiology* / Q000382:microbiology; D006801:Humans; D008875:Middle Aged; D010689:Phlebitis / Q000209:etiology* / Q000382:microbiology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors