EFFECTIVENESS OF AN EDUCATIONAL INTERVENTION FOR THE PREVENTION OF PERIPHERAL VENOUS CATHETER COMPLICATIONS

Almeida, Ana Carolina Nunes de; Pires, Mirele Herculina; Santana, Isabela de Souza; Salgado, Patrícia de Oliveira; Toledo, Luana Vieira; Parreira, Pedro; Braga, Luciene Muniz

doi:10.5380/ce.v27i0.87276

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ORIGINAL ARTICLE • Cogitare Enferm. 27 • 2022 • https://doi.org/10.5380/ce.v27i0.87276 copy

EFFECTIVENESS OF AN EDUCATIONAL INTERVENTION FOR THE PREVENTION OF PERIPHERAL VENOUS CATHETER COMPLICATIONS

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To evaluate the effectiveness of an evidence-based practice educational intervention in preventing peripheral venous catheter complications.

Method

observational study with educational intervention for nursing professionals of a hospital in Minas Gerais, Brazil, about flushing, push-pause and locking techniques. Convenience sampling: 181 catheters in the pre-intervention group and 157 in the post-intervention group. The incidence of complications was evaluated and compared by the Chi-square and Fisher’s exact tests.

Results

the incidence of complications in the post-intervention group was: 4.5% for obstruction (p=0.000), 10.8% for accidental removal (p=0.265) and 1.9% for phlebitis (p=0.847). The use of the flushing, push-pause and locking techniques resulted in a significant reduction in the incidence of obstruction.

Conclusion

the educational intervention enabled updated knowledge and the implementation of flushing, push-pause and locking in nursing practices. The study is a contribution to nursing intervention planning to reduce the occurrence of obstruction.

DESCRIPTORS:
Nursing; Catheterization; Peripheral; Catheter Obstruction; Patient Safety; Evidence-Based Practice.

Complications	Pre-intervention (n=181)	Post-intervention (n=157)	p^{^* * Pearson’s Chi-square or Fisher’s Exact test}
Complications	n (%)	n (%)	p^{^* * Pearson’s Chi-square or Fisher’s Exact test}
Obstruction	37 (20.4)	7 (4.5)	<0.001
Infiltration	17 (9.4)	28 (17.8)	0.023
Accidental Removal	27 (15.0)	17 (10.8)	0.265
Phlebitis	4 (2.2)	3 (1.9)	0.847
Post-removal phlebitis	3 (1.6)	1 (0.6)	0.627

Variables	Pre-Intervention Obstruction n(%)		p^{^* * Pearson’s Chi-square or Fisher’s Exact test; †Catheter - Peripheral Venous Catheter}	Post-Intervention Obstruction n(%)		p^{^* * Pearson’s Chi-square or Fisher’s Exact test; †Catheter - Peripheral Venous Catheter}
Variables	Yes (n=37)	No (n=144)		Yes (n=7)	No (n=150)
Catheter Size† (Gauge)
18	-	4 (2.78	0.583	-	1 (0.6)	1.000
20	8 (21.6)	34 (23.6)	0.798	1 (14.2)	60 (40.0)	0.252
22	28 (75.6)	97 (67.3)	0.329	6 (85.7)	88 (58.6)	0.245
24	1 (2.7)	9 (6.2)	0.690	-	1 (0.6)	1.000
Catheter insertion site†
Back of the hand	12 (32.4)	47 (32.6)	0.981	3 (42.8)	46 (30.6)	0.678
Forearm	17 (45.9)	75 (52.0)	0.582	3 (42.8)	78 (52.0)	0.713
antecubital fossa	2 (5.4)	4 (2.7)	0.604	1 (14.2)	12 (8.0)	0.461
Arm	6(16.2)	18 (12.5)	0.552	-	14 (9.3)	1.000
Catheter dwell time† (days)
≤ 24 hours	5 (13.5)	7 (4.8)	0.129	-	4 (2.6)	1.000
1	8 (21,6)	37 (25,9)	0,766	1 (14,2)	38 (25,3)	0,890
2	13 (35,1)	45 (31,2)	0,799	3 (42,8)	36 (24,0)	0,474
3	7 (18,9)	20 (13,8)	0,612	2 (28,5)	26 (17,3)	0,727
4	4 (10,8)	30 (20,8)	0,242	1 (14,2)	42 (28,0)	0,765
5	-	5 (3,4)	0,628	-	4 (2,6)	1,000

Variables	Pre-Intervention Infiltration n(%)		p^{^* * Teste Qui-quadrado de Pearson ou Exato de Fisher;}	Post-Intervention Infiltration n(%)		p^{^* * Teste Qui-quadrado de Pearson ou Exato de Fisher;}
Variables	Yes (n=17)	No (n=164)		Yes (n=28)	No (n=129)
Catheter Size†(Gauge)
18	-	4 (2.4)	1.000	1 (3.5)	-	0.161
20	3 (17.6)	39 (23.7)	0.766	9 (32.1)	48 (37.2)	0.934
22	12 (70.5)	113 (68.9)	0.886	13 (46.4)	77 (59.6)	0.495
24	2 (11.7)	8 (4.8)	0.239	1 (3.5)	-	0.161
Not Informed	-	-		4 (14.2)	4 (3.1)	-
Place of catheter insertion†
Dorsum of hand	6 (35.2)	53 (32.3)	0.803	11 (39.2)	38 (29.4)	0.309
Forearm	-	6 (3.6)	1.000	14 (50.0)	67 (51.9)	0.852
antecubital fossa	9 (52.9)	83 (50.6)	0.855	1 (3.5)	12 (9.3)	0.466
Arm	2 (11.7)	22 (13.4)	1.000	2 (7.1)	12 (9.3)	1.000
Catheter dwell time† (days)
≤ 24 hours	1 (5.8)	11(6.7)	1.000	1 (3.5)	3 (2.3)	1.000
1	7 (41.1)	38 (23.1)	0.180	11 (39.2)	28 (21.7)	0.087
2	6 (35.2)	52 (31.7)	0.977	8 (28.5)	31 (24.0)	0.793
3	2 (11.7)	25 (15.2)	1.000	7 (25.0)	21 (16.2)	0.412
4	-	34 (20.7)	0.048	1 (3.5)	42 (32.5)	0.001
5	1 (5.8)	4 (2.4)	0.786	-	4 (3.1)	0.904

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[1] Role of Authors:

Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work - Almeida ACN de, Pires MH, Santana I de S, Salgado P de O, Toledo LV, Parreira P, Braga LM; Drafting the work or revising it critically for important intellectual content - Almeida ACN de, Pires MH, Santana I de S, Salgado P de O, Toledo LV, Parreira P, Braga LM; Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved - Almeida ACN de, Pires MH, Santana I de S, Salgado P de O, Toledo LV, Parreira P, Braga LM. All authors approved the final version of the text.