BACKGROUND: There is currently no high grade evidence on which to base decisions about the frequency of intravenous cannula re-sites.
OBJECTIVE: To assess the safety of changing peripheral venous cannulas when clinically indicated.
DESIGN: Randomised controlled trial.
SETTING: A tertiary referral hospital in Brisbane, Australia.
PARTICIPANTS: Two hundred and six hospitalised patients from surgical, medical and orthopaedic wards.
INTERVENTIONS: Peripheral intravenous cannulas were re-sited only when complications occurred (intervention group) or every 3 days (control group).
MAIN OUTCOME MEASURES: The primary endpoint was any unplanned cannula removal, the secondary outcome was cost.
RESULTS: Forty six patients had unplanned removals in the intervention group compared with 41 in the control group [relative risk 1.12, 95% confidence interval 0.81-1.55 (p=0.286)], a non-significant difference. Total duration of peripheral cannulation was similar in both groups (mean 123.3h in the intervention group and 125.9h in the control group: P=0.82) but significantly more re-sites occurred in the control group (167 in intervention group, 202 in the control group: p=0.022). Cost of cannula replacements in the intervention group was AUD$3,183.62 and in the control group AUD$3,837.56 (p=0.006).
CONCLUSION: Re-siting peripheral venous cannulas when clinically indicated compared with changing them routinely every 3 days does not lead to more complications and reduces costs.
| Discipline Area | Score |
|---|---|
| Nurse |  |
| Physician |  |
Nurse rater
As stated in the article, IV cannulation is a routine medical treatment. Treatment methods now result in more damage to the venous system. Unnecessary or premature moving of patent IV sites diminish a finite resource which is the venous system. I think this article supports a more conservative approach to IV re-sites.
Nurse rater
A great cost-saving idea. ITwill be nice to see more research in this area.
Nurse rater
This is a very good article combining clinical contribution based on well-designed study.
Nurse rater
Timely and relevant. Enjoyed the hypotheses and would like to see several clinical trails performed state side.
Physician rater
Who picked this as an emergency medicine topic? Searching the article, the term “emergency department” is used once and these patients are all in-patients. While we start lots of IVs in the ED and I know many EDs are over-crowded, surely we aren`t considered an in-patient unit! This is NOT an ED study and shouldn’t have been selected as such.
Physician rater
This is not of interest to emergency physicians who rarely care for patients longer than 24 hours. IVs inserted in the ED are almost never changed in the ED unless they ``blow`` or pop out. This study is very much about nursing issues in hospitalized patients and as such has little or no bearing on EM.
, McMaster University