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Observational Study of Peripheral Intravenous Catheter Outcomes in Adult Hospitalized Patients: A Multivariable Analysis of Peripheral Intravenous Catheter Failure

Open access
Marsh, Nicole, Webster, Joan, Larsen, Emily, Cooke, Marie, Mihala, Gabor, Rickard, Claire M.·2018·Journal of Hospital Medicine

Abstract

BACKGROUND: Almost 70% of hospitalized patients require a peripheral intravenous catheter (PIV), yet up to 69% of PIVs fail prior to completion of therapy. OBJECTIVE: To identify risk factors associated with PIV failure. DESIGN: A single center, prospective, cohort study. SETTING: Medical and surgical wards of a tertiary hospital located in Queensland, Australia. PARTICIPANTS: Adult patients requiring a PIV. MEASUREMENTS: Demographic, clinical, and potential PIV risk factors were collected. Failure occurred if the catheter had complications at removal. RESULTS: We recruited 1000 patients. Catheter failure occurred in 512 (32%) of 1578 PIVs. Occlusion/infiltration risk factors included intravenous (IV) flucloxacillin (hazard ratio [HR], 1.98; 95% confidence interval [CI], 1.19‐3.31), 22‐gauge PIVs (HR, 1.43; 95% CI, 1.02‐2.00), and female patients (HR, 1.48; 95% CI, 1.10‐2.00). Phlebitis was associated with female patients (HR, 1.81; 95% CI, 1.40‐2.35), bruised insertion sites (HR, 2.16; 95% CI, 1.26‐3.71), IV flucloxacillin (HR, 2.01; 95% CI, 1.26‐3.21), and dominant side insertion (HR, 1.39; 95% CI, 1.09‐1.77). Dislodgement risks were a paramedic insertion (HR, 1.78; 95% CI, 1.03‐3.06). Each increase by 1 in the average number of daily PIV accesses was associated (HR 1.11, 95% CI 1.03‐1.20)–(HR 1.14, 95% CI 1.08‐1.21) with occlusion/infiltration, phlebitis and dislodgement. Additional securement products were associated with less (HR 0.32, 95% CI 0.22‐0.46)–(HR 0.63, 95% CI 0.48‐0.82) occlusion/infiltration, phlebitis and dislodgement. CONCLUSION: Modifiable risk factors should inform education and inserter skill development to reduce the currently high rate of PIV failure.

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Metadata

Authors
Marsh, N., Webster, J., Larsen, E., Cooke, M., Mihala, G., & Rickard, C. M.
Venue
Journal of Hospital Medicine
Publisher
Wiley
Published
2017-10-18
Volume
13
Issue
2
Pages
83-89
ISSN
  • 1553-5592 (ISSN-L)
  • 1553-5606
OpenAlex
W2765339054
Cited by
267
References
34
FWCI
25.83
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: Observational Study of Peripheral Intravenous Catheter Outcomes in Adult Hospitalized Patients: A Multivariable Analysis of Peripheral Intravenous Catheter Failure. https://app.cochat.ai/papers/10.12788/jhm.2867
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Marsh, N., Webster, J., Larsen, E., Cooke, M., Mihala, G., & Rickard, C. M. (2018). Observational Study of Peripheral Intravenous Catheter Outcomes in Adult Hospitalized Patients: A Multivariable Analysis of Peripheral Intravenous Catheter Failure. Journal of Hospital Medicine. https://doi.org/10.12788/jhm.2867

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