Peripheral Intravenous Catheter Complication Rate Comparison of Two Different Catheter-Stabilization Systems

Study Overview
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Brief Summary
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Approximately 300 million short peripheral intravascular catheters (PIVs) were sold in the U.S. in 2009. These short (< 3 inches) peripherally inserted IV catheters are vital for providing patients with needed: 1) fluid, electrolyte, nutrient and blood product replacement, 2) medicines and 3) diagnostic solutions (dyes). However, these IV catheters have inherent risks or potential complications which may result from poor catheter securement or stabilization. When a PIV catheter is not properly secured, motion and micro-motion within the vessel cause injury to the vein. This damage to the vein is a primary cause of phlebitis, a distressing complication of PIV therapy. Additional complications of inadequate stabilization of the PIV catheter are infiltration, leaking at the insertion site, pain, infection and dislodgement. According to Royer (2003), the most common reason for PIV catheter failure is infiltration and dislodgement. Infiltration is more dependent on keeping the extremity still, where phlebitis is dependent on injuries due to the chemical nature of the drugs and fluids infused or by the physical trauma to the endothelium from IV pushes. The results of these complications are costly and can be serious if another vein cannot be immediately accessed or if the infiltrated infusate causes tissue necrosis. An unscheduled restart of another PIV catheter causes a delay in patient treatment, patient discomfort, patient dissatisfaction, safety concerns, nursing interruptions and additional costs. Actual costs associated with PIV catheter restarts include materials and nursing resources; yet intangibles such as, treatment for patient complications and patient dissatisfaction may be far more costly. One way to reduce the incidence of PIV catheter-associated complications is to use technologies that help reduce catheter movement thereby improving catheter stabilization. In addition to stabilization platforms added to the peripheral IV catheter design, catheter stabilization devices and modified transparent film dressings also help to reduce catheter movement and could possibly eliminate the need for routine catheter site changes. Therefore, the purpose of this study is to: 1) compare the number of PIV securement-related complications and PIV catheter restarts of one stabilization system to another stabilization system and 2) to determine which system provides a cost savings.

Detailed Description
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See brief summary

Official Title
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Peripheral I.V. Catheter Complication Rate Comparison of Two Different Catheter-Stabilization Systems

Conditions
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Catheter Complications

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: At least 18 years of age, unless an emancipated minor A patient who is admitted or going to be admitted to the hospital Requires peripheral IV therapy (catheter) for an anticipated 72 hours or longer. Has an insertion site in the forearm or hand free of deformities, phlebitis, infiltration, dermatitis, burns, lesions or tattoos Demonstrates cooperation with a catheter insertion and the securement protocol. Exclusion Criteria: Is a current participant or a past participant in this study If the study PIV catheter will cross a joint or the catheter hub will hang off the fingers If the study PIV catheter site will be placed below an old infusion site If the study PIV site needs to be immobilized with a splint or other devices Has a documented or a known allergy or sensitivity to a medical adhesive product such as transparent film adhesive dressings, tapes or liquid skin protectants Requires the application of a gauze pad, a topical ointment or solution under the dressing in addition to the prep(s) required in the protocol Has or has had a previous IV catheter related phlebitis or infiltration during this hospitalization. Will have a vesicant administered through the study catheter, e.g. Dilantin Will require a power injection for a radiologic procedure during participation in this study

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Stabilization system A<br>A commercialized stabilization dressing using a winged PIV catheter. | |
| Stabilization System B<br>A commercialized stabilization device using a non-winged PIV catheter | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| PIV Catheter complication rates | The primary endpoint for the study is the difference between the number and type of PIV-related complications (phlebitis, infiltration, dislodgement, leakage, local site infection and catheter line associated infection) between the two stabilization groups. | Anticipated to be up to 4 days per participant | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cost effectiveness | The secondary endpoints are overall and specific complication rates, incidence of unscheduled restarts, incremental cost effective ratio for one stabilization system to another stabilization system. | Anticipated to be up to 4 days per participant | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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PIV therapy