Effect of Skin Antisepsis on Phlebitis
Condition: Phlebitis
MeSH terms: Phlebitis
Study type: Interventional

Summary: 
      Peripheral intravenous catheters have application such as fluid, blood, medication and feding
      fluids. Although it is a life-savingtool, it can lead to some complications as a result of
      incorrect applications. Phlebitis, which is defined as inflammation of the tunica intima
      layer of the vein, is characterized by pain, redness, tenderness, palpable stiffness and
      increased temperature. As can be seen during catheter application, it can develop within
      48-96 hours after catheter removal. Instudies performed, the rate of phlebitis development
      was 0.1-63.3% in patients with peripheral intravenous catheters, in Turkey, this rate varies
      between 11% and 67%.

      Phlebitis; can be originated mechanical, chemical and bacterial. Various guidelines are
      available from evidence based on research results to prevent and reduce phlebitis
      development. In our country, National Vascular Access Management Guide is used.

      One of the principles in the National Guidelines for Vascular Access Management for the
      prevention of phlebitis is skin antisepsis. The guideline recommends a 70% alcohol solution
      containing>0.5% chlorhexidine for skin antisepsis and reports that povidone-iodine or only
      70% alcohol solution can be used in the absence or contraindication. Infusion Nurses Society
      (INS, 2016) recommends using the 'Phlebitis Scale' in the early diagnosis of phlebitis.

      In this study, investigator aimed to compare the antiseptic effects of 2% chlorhexidine and
      70% alcohol which are used as antiseptic in preventing phlebitis development while providing
      skin antisepsis, which is one of the basic principles in the application of peripheral
      intravenous catheter. This study is a randomized controlled clinical study and the population
      will consist of patients (participants)hospitalized in the Surgery -1 Department of Balcalı
      Hospital, Faculty of Medicine, Çukurova University.

      As a data collection tool; 'Patient Information Form' and 'İnformation Form for İntravenous
      Catheter Application to the Patient' created by there searcher, to evaluate phlebitis
      formation "Phlebitis Scale'' which published by the Infusion Nurses Society (INS, 2016) will
      be used. A transparent millimeter ruler will be used
    

Detailed description: 
      In the study, data were collected for 9 months between January 2020 and September 2020.

      Before starting the research, the nurses in the clinic were informed about the work to be
      done. Participants who were admitted to the surgical service, who met the inclusion criteria
      and accepted to participate in the study on a voluntary basis were separated into two groups
      by block randomization method. Then, the participants assigned to the groups were informed
      about the study and the "Patient Information Form" was administered by the researcher after
      obtaining the consent of the individuals.

      In order to eliminate the bias regarding the antiseptic used while inserting the catheter,
      investigator did not have information about the solution used, participants and nurses in the
      clinic. The solutions were prepared by the nurse in charge of the Surgery 1 Clinic. Both
      solutions were put into bottles of the same color and size. It was a light proof bottle in
      both bottles. The usage dates of both solutions were checked. As they were transferred to
      different bottles, the bottles and solutions were renewed once a month by the nurse in charge
      with the recommendation of the hospital infection control committee. A pink sticker was
      attached to one of the bottles (to cover the entire bottle), and a blue sticker to the other
      (to cover the entire bottle). Which color and which solution was known only by the clinic
      responsible nurses.

      As stated in the statement of the nurse in charge of the surgery 1 service, he wrote the
      color which solution was on a piece of paper and put it in a sealed envelope. D He prepared
      two of the same envelopes and gave the other one to the responsible nurse of the General
      Surgery-2 Clinic. The envelopes were kept by both responsible until the end of the work.
      Solutions could not be distinguished in terms of color and odor. After the study comes from
      statistics, when looking at the solutions by opening the closed envelope; It was observed
      that 2% chlorhexidine was used in the participants in group 1 (blue solution) selected by
      randomization method, and 70% alcohol was used in the second group (pink solution) by
      investigator.İ.V. A sterile, transparent, semi-permeable, self-adhesive catheter stabilizer
      was used as a catheter cover for all patients in Group 1 and Group 2. İ.V. After
      catheterization, "Information Form Regarding IV Catheter Application to Patient" was filled
      in for each participant.

      Desefin and (active substance: ceftriaxone) biteral (active substance: ornidazole) and parol
      (active substance: paracetamol) as an analgesic were administered through the intravenous
      catheter inserted for the study. It was ensured that these drugs were sent in the form of
      infusion. Therefore, verbal consent was obtained from the participants to apply the catheter
      for the second time, except for the intravenous catheter attached, if the patient was to
      receive different intravenous therapy.

      After the application, phlebitis development status was evaluated with the "Phlebitis Scale"
      published by the Infusion Nurses Association. As part of the follow-up of phlebitis,
      millimetric measurements were made with a transparent ruler and the degree of phlebitis was
      determined bu intestigator. The scale was applied every 8 hours for 72 hours by investigator.
    

Intervention name(s): %2 Klorheksidin
Intervention type(s): Other
Intervention description(s): Effect on phlebitis
Other intervention name(s): % 70 Alchol
Allocation: Randomized
Intervention model: Crossover Assignment
Intervention model description: Randomize,controlled double-blind clinical trials
Masking: Double (Participant, Investigator)
Primary purpose: Prevention