Simon Bugden1, Karla Shean2, Mark Scott3, Gabor Mihala4, Sean Clark3, Christopher Johnstone3, John F Fraser5, Claire M Rickard5. 1. Department of Emergency Medicine, Caboolture Hospital, Queensland, Australia; University of Queensland, Brisbane, Queensland, Australia; NHMRC Centre of Research Excellence in Nursing, Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Nathan Campus, Brisbane, Queensland, Australia; Critical Care Research Group, the Prince Charles Hospital and University of Queensland, Brisbane, Queensland, Australia. Electronic address: simon.bugden@health.qld.gov.au. 2. Department of Emergency Medicine, Caboolture Hospital, Queensland, Australia. 3. Department of Emergency Medicine, Caboolture Hospital, Queensland, Australia; University of Queensland, Brisbane, Queensland, Australia. 4. Centre for Applied Health Economics, School of Medicine, Menzies Health Institute Queensland, Griffith University, Logan Campus, Queensland, Australia. 5. NHMRC Centre of Research Excellence in Nursing, Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Nathan Campus, Brisbane, Queensland, Australia; Critical Care Research Group, the Prince Charles Hospital and University of Queensland, Brisbane, Queensland, Australia.
Abstract
STUDY OBJECTIVE: Peripheral intravenous catheters are the most common invasive device in health care yet have very high failure rates. We investigate whether the failure rate could be reduced by the addition of skin glue to standard peripheral intravenous catheter care. METHODS: We conducted a single-site, 2-arm, nonblinded, randomized, controlled trial of 380 peripheral intravenous catheters inserted into 360 adult patients. The standard care group received standard securement. The skin glue group received standard securement plus cyanoacrylate skin glue applied to the skin insertion site. The primary outcome was peripheral intravenous catheter failure at 48 hours, regardless of cause. Secondary outcomes were the individual modes of peripheral intravenous catheter failure: infection, phlebitis, occlusion, or dislodgement. RESULTS:Peripheral intravenous catheter failure was 10% lower (95% confidence interval -18% to -2%; P=.02) with skin glue (17%) than standard care (27%), and dislodgement was 7% lower (95% confidence interval -13% to 0%; P=.04). Phlebitis and occlusion were less with skin glue but were not statistically significant. There were no infections. CONCLUSION: This study supports the use of skin glue in addition to standard care to reduce peripheral intravenous catheter failure rates for adult emergency department patients admitted to the hospital.
RCT Entities:
STUDY OBJECTIVE: Peripheral intravenous catheters are the most common invasive device in health care yet have very high failure rates. We investigate whether the failure rate could be reduced by the addition of skin glue to standard peripheral intravenous catheter care. METHODS: We conducted a single-site, 2-arm, nonblinded, randomized, controlled trial of 380 peripheral intravenous catheters inserted into 360 adult patients. The standard care group received standard securement. The skin glue group received standard securement plus cyanoacrylate skin glue applied to the skin insertion site. The primary outcome was peripheral intravenous catheter failure at 48 hours, regardless of cause. Secondary outcomes were the individual modes of peripheral intravenous catheter failure: infection, phlebitis, occlusion, or dislodgement. RESULTS: Peripheral intravenous catheter failure was 10% lower (95% confidence interval -18% to -2%; P=.02) with skin glue (17%) than standard care (27%), and dislodgement was 7% lower (95% confidence interval -13% to 0%; P=.04). Phlebitis and occlusion were less with skin glue but were not statistically significant. There were no infections. CONCLUSION: This study supports the use of skin glue in addition to standard care to reduce peripheral intravenous catheter failure rates for adult emergency department patients admitted to the hospital.
Authors: Russell Piper; Peter J Carr; Lachlan J Kelsey; Andrew C Bulmer; Samantha Keogh; Barry J Doyle Journal: Sci Rep Date: 2018-02-21 Impact factor: 4.379
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