PREVENTION OF PERIPHERAL VENOUS CATHETER COMPLICATIONS WITH AN INTRAVENOUS THERAPY TEAM - A RANDOMIZED CONTROLLED TRIAL

Background: More than 25 million patients have peripheral intravenous (IV) catheters placed each year in US hospitals. Infusion therapy is b elieved to account for one third of all nosocomial bacteremias. Method s: We performed a randomized, prospective, controlled study in a unive rsity-affiliated hospital to determine whether the use of an IV therap y team decreases peripheral venous catheter-related complications in a dult medical patients. Patients were randomized to undergo peripheral catheter insertion and/or maintenance either by the IV team or by medi cal house staff. A dedicated observer reviewed catheter sites daily; f indings were applied to a scoring system to define the severity of com plications. Bacteremic complications were reviewed by a physician. Res ults: Patients with catheters started by the house staff and maintaine d by ward nursing staff more often had signs or symptoms of inflammati on (21.7%) than did patients with catheters maintained by the IV team (7.9%) (P < .001). Patients monitored by the IV team had a greater mea n number of catheters placed per patient than did patients monitored b y house staff (2.1 and 1.6, respectively) (P < .01). Three episodes of catheter-related sepsis occurred in house staff patients and none in IV team patients (P = .004). Conclusions: An IV therapy team significa ntly reduced both local and bacteremic complications of peripheral IV catheters. Timely replacement of the catheter appeared to be the most important factor in reducing the occurrence of complications.