• Title/Summary/Keyword: Infusion phlebitis

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The Effect of Increased Dilution Volume and Prolonged Infusion Time of Vancomycin on Incidence of Adverse Reactions through Peripheral Venous Cannulae (말초정맥을 통한 반코마이신희석과 주입시간연장이 부작용발생에 미치는 영향)

  • Oh, Myeong Ju;Kim, Mae Ja
    • Korean Journal of Adult Nursing
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    • v.12 no.2
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    • pp.196-208
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    • 2000
  • The purpose of the study was to explore the effect of 2 hour infusion of vancomycin(1g) in 200ml of isotonic saline every 12 hour on the frequency of "red man syndrome", phlebitis and length of peripheral catheter placement of infected patients, in order to provide safe infusion method for reducing vancomycinin-duced RMS and phlebitis. The subjects of the study consisted of 16 hospitalized patients; 3 oncology and gastro-intestinal patients, 1 neurological patient, 6 thoracic surgical patients and 6 orthopedic patients, who had received vancomycin from July to October in 1999 at S-hospital. The dependent variables were the incidence of RMS, phlebitis and the length of peripheral catheter placement. The incidence of RMS was checked by an inspector at the first night whenever the infusion method of vancomycin was changed. RMS was observed every 15 minutes during an hour for symptoms of RMS such as itching, erythema, chest pain and systolic blood pressure. Incidence of phlebitis was assessed by inspector twice a day from the insertion of peripheral catheter to the removal of the catheter. The data were analyzed by percentage, mean, $X^2$-test, t-test, repeated ANOVA, and logistic regression analysis using the SPSSWIN program. The results are summarized as follows; 1. No significant difference was identified in frequency of RMS between the experimental group and control group. 2. There was no significant difference in the change of systolic blood pressure as the time goes on between the experimental group and control group. 3. The incidence of phlebitis was significantly lower in the experimental group than in the control group. 4. The length of peripheral catheter placement was significantly longer in the experimental group than in the control group. 5. Other drugs administrated with vancomycin didn't influence the occurrence of phlebitis. However, the infusion method of vancomycin influenced the occurrence of phlebitis. The results suggest that 2 hour infusion of vancomycin(1g) in 200ml of isotonic saline every 12 hours may decrease the incidence of phlebitis and increase the length of peripheral catheter placement compared to 1 hour infusion of vancomycin(1g) in 100ml of isotonic saline every 12 hours. However, it does not reduce the incidence of RMS.

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Meta-analysis of Inline Filtration Effects on Post-infusion Phlebitis Caused by Particulate Contamination of Intravenous Administration

  • Ku, Hye-Min;Kim, Ji-Yeon;Kang, Suk-Hyun;Lee, Eui-Kyung
    • Journal of Pharmaceutical Investigation
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    • v.40 no.4
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    • pp.225-230
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    • 2010
  • The particulate contamination of intravenously administered fluid has been of major concern. One of the most common complications associated with long term i.v. therapy is post-infusion phlebitis (PIP). We undertook a systematic review and meta-analysis of the effect of inline filters on PIP. An electronic search of Medline, KoreaMed, and KRIST was conducted to identify randomized controlled trials evaluating the effect of inline filters. Meta-analysis was undertaken using STATA 10. A total of 62 literatures were retrieved, of which 7 were included in meta-analysis. Inline filtration for intravenous infusion significantly reduced by 39% of the incidence of phlebitis, with a relative risk of 0.61 (95% CI 0.41-0.90, p=0.012). Therefore, inline filtration is a highly effective means of decreasing the incidence of infusion phlebitis and should be considered as a part of intravenous therapy.

The effect of the aseptic dressing method on infusion phlebitis (정맥 주사시 멸균 드레싱이 정맥염 감소에 미치는 효과)

  • Lee Kyu-Eun;Yom Young-Hee;Oh Jum-Sook;Kim Kyung-Min
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.2
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    • pp.177-191
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    • 2000
  • The purpose of this study to conform the effect of the aseptic dressing method to prevent infusion phlebitis. One quaxi-experimental, nonequvalent control group post-test design was used to evaluate prevention of phlebitis between a control group and an experimental group. The data for the control group were collected from 100 hospitalized patients from July 1 to November 30, 1999. The data for the experimental group were collected from 100 hospitalized patients from December 1, 1999 to March 5, 2000. The control group used paper tape on the IV site and the experimental group used a sterile gauze dressing which was changed every 24 hours. Two sets of instruments were used for this study. First, instrument developed Weinstein(1993) and modified by the researcher was used for judging phlebitis. The second, instrument developed Park(1996) was used for assessment records concerning the phlebitis which developed. Catheter sites were inspected on a daily basis by unit nurses and development of phlebitis was grade and documented. Data were analyzed using $x^2-test$ and stepwise regression The results are summarized as follows : 1. The incidence of phlebitis according to the duration of catheter insertion decreased in the experimental group($x^2=3.56$, p<.05). 2. The incidence of phlebitis according to the duration of catheter insertion decreased in the experimental group($x^2=28.79$, P<.0001). 3. No significant difference was found between the experimental and control groups in the severity of phlebitis. 4. A statistically significant difference between the two groups was found in the incidence of phlebitis according to the location of the insertion site. 5. No statistically significant difference between two groups was found in the incidence of phlebitis by age 6. A statistically significant difference between two groups was found in the incidence of phlebitis by sex($x^2=3.88$, p<.05) 7. Further study revealed that the duration of catheter and sex were predictors of occurrence of the phlebitis, explaining 38.2%, 14.2% of the total variance respectively. In conclusion, the aseptic dressing method is recommended to be prevent infusion phlebitis.

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The Development of Phlebitis in Relation to 18 Gauge Peripheral Intravenous Catheter Dwell Time among Surgical Patients (수술환자 18 Gauze 말초 정맥관 유지시간과 정맥염 발생률)

  • Choi, Jung Hee;Kang, Min Ja;Park, Youn Hee;Hong, Bo Ra;Lee, Dong Sook
    • Journal of Korean Clinical Nursing Research
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    • v.21 no.2
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    • pp.188-195
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    • 2015
  • Purpose: The purpose of this study was to evaluate the appropriateness of the replacement time intervals of 18 gauge peripheral intravenous catheters (PICs) by investigating the development of phlebitis. Methods: The subjects were 200 hospitalized patients over 18 yrs old aged who have 18 gauge PICs placed for surgery. After the insertion of PICs, the researcher monitored the insertion site daily for 96 hours for any signs of phlebitis. Results: Phlebitis developed in 25.7% of patients. Patients who developed phlebitis were significantly older and were receiving fluids with faster infusion rate. However, patients with and without phlebitis were not different by gender, insertion site, fluid osmolality, or pH of drugs administered. The incidence rate of phlebitis was higher than 10%(12.9%) starting 24~48 hours after the insertion of 18 gauge PICs. Conclusion: It is recommended to replace 18 gauge PICs within 24~48 hours after insertion. Close monitoring of the PICs insertion site for the signs of phlebitis is recommended.

Development and Effectiveness of Practice Application Program of Intravenous Infusion Evidence-Based Nursing Practice Guideline - for Small and Medium Sized Hospitals (근거기반 정맥주입요법 간호실무지침 실무적용 프로그램 개발 및 평가 - 중소병원을 대상으로)

  • Hong, Inhwa;Eun, Young
    • Journal of Korean Academy of Nursing
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    • v.50 no.6
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    • pp.863-875
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    • 2020
  • Purpose: This study was conducted to develop and test the effects of a program for practice application of intravenous infusion evidence based nursing practice (EBP) guidelines in small and medium-sized hospitals. Methods: A mixed method research design was used, combining non-equivalent control group pre-post test design with qualitative study analysis. The subjects consisted of 55 nurses. The practice application program was developed based on the Advancing Research and Clinical practice through close Collaboration (ARCC) model. Data were collected for analysis in the following areas: nurses' EBP organizational culture and readiness, EBP beliefs, EBP implementation, importance about intravenous infusion, and performance about intravenous infusion, with data assessed using valid and reliable instruments. Patient outcomes were collected from the hospital's medical records. Data were analyzed using t-test, χ2-test, and Shapiro-Wilk test, with qualitative content analysis used for interview data. Results: Following the intervention, nurses' EBP organizational culture and readiness, EBP beliefs, EBP implementation, and performance of intravenous infusion and perceptions of its importance showed significant improvement in the experimental group. Phlebitis rates decreased in the experimental group compared to the control group. Conclusion: This program is effective to improve nurse's perception and practice of evidence based nursing. Therefore we recommend to use this program at same levels of hospitals.

A Study on the Relationship Between Length of Time and Contamination in Open Intravenous Solutions (정맥주사용 수액의 개방후 시간경과에 따른 오염도에 관한 실험연구)

  • 김일원
    • Journal of Korean Academy of Nursing
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    • v.16 no.1
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    • pp.67-80
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    • 1986
  • The use of intravenous solutions for fluid replacement has become an integral part of patient care, This widespread use of intravenous solutions has increased the risk of contamination that can lead to septicemia and phlebitis. The literature regarding contamination of in use intravenous solutions recommends a standard 24-hour time limit on the use of these fluids. But the desings of these studies did not incorporate a time variable related to contamination. In other studies, however, time was a manipulated variable: but data regarding the onset of contamination were conflicting. Because published reports conflict with regard to a time standard related to the use of intravenous therapy, additional empirical data are needed upon which to base the standards of care regulating use of intravenous therapy. This study investigated rate of contamination in simulated in-use intravenous solutions to obtain data from which to recomend a standard time period for the administration of intravenous solutions. In this study samples were drawn from 60 bottles of 5% D/W solution at predetermined time intervals over 48 hours and samples were inoculated to Thio-glychollate Broth. After 10 days' culturing in that Broth, samples were cultured on blood agar plates for 18∼48 hours to determine the rate of contamination. was found at all time Period, regardless of the presence or absence of nurse's gloving in the preparation of fluids, the location in which the experimentations were performed, the contamination level of surrounding air, or the length of time during which solutions were opened. Data from this study support the use of a 48-hour time period on which to base the standard involved in ready-to-use simple intravenous solutions without additives. In emergency departments and critical care areas where intravenous solutions are prepared in advance, the suggested time standard supported by the data generated from this study is 48 hours, not 24 hour. Data from this study support a 24-hour time standard for changing in-use intravenous solutions when the contamination results from the manipulation of intravenous infusion system by hospital personnel, or from some other exogenous sources during administration. Because contamination that does occur within 48 hours in intravenous solutions must be introduced from some exogenous sources, further empirical studies based on the identification of sources of contamination and factors that affect the rate of contamination, are needed to investigate the currently employed standard of intravenous therapy and to provide the patient with more efficient and safer intravenous thereapy.

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