Evaluation of phlebitis adverse event occurrence in patients of a Clinical Inpatient Unit

Furlan, Maryana da Silva; Lima, Antônio Fernandes Costa

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 55 • 2021 • https://doi.org/10.1590/S1980-220X2020017103755 copy

Evaluation of phlebitis adverse event occurrence in patients of a Clinical Inpatient Unit^* * Extracted from the dissertation: “Custo direto da ocorrência do evento adverso flebite em uma Unidade de Internação Clínica”, Escola de Enfermagem, Universidade de São Paulo, 2019.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To analyze the causes and reasons associated with the occurrence of phlebitis in a Inpatient Medical Unit in a large and private general hospital.

Method

Quantitative, exploratory-descriptive, retrospective and documentary research, carried out by consulting the electronic forms of notification of the occurrence of phlebitis in 2017.

Results

A total of 107 phlebitis related to 96 patients were reported, most of them (91.7%) with phlebitis, being male (53.1%), aged 60-69 years old (23.0%) and with a hospital stay of less than four days (30.2%). Most (68.2%) of the notifications were made by nurses, with the occurrence of phlebitis predominating in devices with less than 24h (38.3%); with the classification of phlebitis grade 2 (45.8%); with antibiotics infusion (46.7%); with the location of the bed far from the nursing station (52.3%); and with the presence of a companion (82.2%). The damage classification indicated that 93.5% of the patients suffered mild damage, 4.7% moderate damage and 1.9% did not suffer any damage.

Conclusion

Knowing the causes and reasons associated with the occurrence of phlebitis can support decision-making, management and care processes regarding investments in preventive or risk mitigation strategies.

Inpatients; Catheterization, Peripheral; Phlebitis; Nursing Care; Hospital Units

Variables	N	%
Gender
Female	45	46.9
Male	51	53.1
Age group
10-19	1	1.0
20-29	3	3.1
30-39	15	15.6
40-49	15	15.6
50-59	13	13.5
60-69	22	23.0
70-79	13	13.5
80-89	10	10.4
90-99	4	4.1
Length of hospital stay (days)
< 4 days	29	30.2
5-7 days	25	26.0
8-11 days	25	26.0
> 12 days	17	17.8
TOTAL	96	100.0

Variables	N	%
Type of device
Jelco®	56	52.3
Intima®	51	47.7
Length of device in the same place
24 h	41	38.3
48 h	28	26.1
72 h	18	16.8
96 h	6	5.6
120 h	6	5.6
144 h	5	4.8
168 h	2	1.9
Post-removal	1	0.9
Phlebitis degree*
Grade 1	32	29.9
Grade 2	49	45.8
Grade 3	24	22.4
Grade 4	2	1.9
Drug category
Analgesic	9	8.4
Antihistamine	1	0.9
Anti-inflammatory	2	1.9
Antianemic	1	0.9
Antiemetic	3	2.8
Antifungal	3	2.8
Antibiotic	50	46.7
Antiviral	7	6.5
Crystalloid	1	0.9
Diuretic	1	0.9
Immunoglobulin	10	9.3
Electrolytic solution	15	14
Lack of registration	4	3.7
Bed location
Near the nursing station	51	47.7
Far from the nursing station	56	52.3
Companion
Yes	88	82.2
No	19	17.8

Phlebitis Degree*		Grade 1		Grade 2		Grade 3		Grade 4		Pearson’s χ²**
Variables		N	%	N	%	N	%	N	%	Sig.
Pre-existing diseases
Systemic Arterial Hypertension	No	31	36.5%	34	40.0%	18	21.2%	2	2.4%	0.02
Systemic Arterial Hypertension	Yes	1	4.5%	15	68.2%	6	27.3%	0	0.0%	0.02
Mental and behavioral disorders	No	31	30.7%	45	44.6%	24	23.8%	1	1.0%	0.02
Mental and behavioral disorders	Yes	1	16.7%	4	66.7%	0	0.0%	1	16.7%
Neuropathy	No	31	30.1%	47	45.6%	24	23.3%	1	1.0%	0.005
Neuropathy	Yes	1	25.0%	2	50.0%	0	0.0%	1	25.0%	0.005
Chronic Kidney Failure	No	31	30.1%	46	44.7%	24	23.3%	2	1.9%	0.611
Chronic Kidney Failure	Yes	1	25.0%	3	75.0%	0	0.0%	0	0.0%	0.611
Dyslipidemia	No	31	32.6%	40	42.1%	22	23.2%	2	2.1%	0.166
Dyslipidemia	Yes	1	8.3%	9	75.0%	2	16.70%	0	0.0%	0.166
Sepsis	No	31	30.4%	48	47.1%	21	20.6%	2	2.0%	0.228
Sepsis	Yes	1	20.0%	1	20.0%	3	60.0%	0	0.0%	0.228

Variables		Catheter stay time (in days)*
Variables		Median	25%	75%	Sig.**
Phlebitis degree	Grade 1	2.5	2.0	4.0	0.173
	Grade 2	3.0	2.0	5.0
	Grade 3	3.0	2.0	3.5
	Grade 4	6.0	3.0	9.0
Damage classification	None	2.0	1.0	3.0	0.810
	Mild	3.0	2.0	4.0
	Moderate	3.0	3.0	4.0
	Severe	-	-	-
Risk assessment	No risk	2.0	1.0	3.0	0.324
	Low	3.0	2.0	4.0
	Moderate	3.0	3.0	4.0
	High	3.0	2.0	4.0

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Maryana da Silva Furlan Rua Peixoto Gomide, 379, apto. 608, Jardim Paulista CEP 01409-001 – São Paulo, SP, Brazil maryana.silvafurlan@gmail.com

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Evaluation of phlebitis adverse event occurrence in patients of a Clinical Inpatient Unit* * Extracted from the dissertation: “Custo direto da ocorrência do evento adverso flebite em uma Unidade de Internação Clínica”, Escola de Enfermagem, Universidade de São Paulo, 2019.

ABSTRACT

Objective

Method

Results

Conclusion

Evaluation of phlebitis adverse event occurrence in patients of a Clinical Inpatient Unit^* * Extracted from the dissertation: “Custo direto da ocorrência do evento adverso flebite em uma Unidade de Internação Clínica”, Escola de Enfermagem, Universidade de São Paulo, 2019.