Incidence Severity and Risk Factors of Peripheral Intravenous Research 2022

Running head: NUM 1204 1
Incidence, Severity and Risk factors of Peripheral
Intravenous Cannula‐induced Complications: An
Observational Prospective Study
By
(Name of Student)
(Institutional Affiliation)
(Date of Submission)

NUM 1204 2
Introduction
A Review of a document by Dragna Simim et al (2016) is here presented critically
appraise the authors abstract the methods of statistics collection and analysis obstacles, findings
and relevance to the clinical training of the situation matter of Titled Incidence, severity and
chance factors of peripheral intravenous cannula‐induced complications: An observational
prospective take a look at (Siin, Miltinović, Tukulov, & Bkić, 2019). It addresses the prevention
of nosocomial infections of that are of fantastic situation in nursing. As such important appraisal
assists nurses to correctly practice studies evidence to the nursing exercise (Coutney &
McCutcheon, 2019).
Author, Title, Abstract
Greenhalgh states that a well-dependent identify includes the state of affairs being
studied, populace and technique of look at(Greenhalgh, 2014)The title Incidence, severity and
hazard factors of peripheral intravenous cannula‐caused headaches: An observational potential
examine addresses the focal point of the research goals and method but does no longer suggest
the location and populace being studied.
Simin et al ( Dragna Simin, Dragna Milutinovic,Vesna Turkulov,Snezana Brkic) are
researchers primarily based on the University of Novi sad in Serbia inside the Faculty of
Medicine, departments of nursing and infectious illnesses (Simin et al., 2019). However their
actual qualifications aren't stated. A search to validate their information, qualifications, and enjoy
changed into performed on the Scopus database an abstract and quotation database for peer-
reviewed literature. The findings were that over a 10 yr length they were concerned in the
publication of numerous magazine articles. They are participants of ORCID a now not for

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Earnings Company had been researchers are diagnosed for the contributions and proportion
information globally. The article was published via the WILEY Journal of scientific nursing a
good worldwide peer-reviewed clinical magazine of nursing. This goes to mention it was
reviewed by individuals who are specialists inside the situation depend.
No proof of bias or invested hobby became cited because the authors have declared that there is
no battle of interest and that they acquired no economic assist for the paper authorship and ebook
of the journal (Simin et al., 2019).
The summary gives a preview of the primary sections of a magazine to expedite the
category and relevance to scientific practice (Alspach, 2017). While this abstract does no longer
state the first-class of the study its miles well organized because it follows the same set up as the
extended paper. The abstract includes the purpose and goals, layout that's an observational
prospective observe. The technique states the contributors and information gathered adhered the
international STROBE tips of observational studies on research reporting in epidemiology. The
results. Conclusion and relevance to clinical exercise also are said.The abstract is the preliminary
section of the journal article that captures the reader, s interest in the challenge be counted if
unclear for most readers it discourages from going beyond the summary (Alspach, 2017).
Literature Review
The authors looked at a wide range of research articles from 1991 to 2018 to support
their research Most of the literature was on phlebitis one of them a cross-sectional study was
recently done in 2018 by Alexandrou et al., 2016 highlighting Phlebitis as a global clinical
challenge.Helm et al put the average incident rate of phlebitis at 22.7% and infiltration with an
average incident rate of 14.9%. The author cites minimal supporting literature has been provided

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regarding management of PIVC and local complications as the author cites limited data
availability due to under-reporting of local complication and reasons for removal and poor
documentation (Simin et al., 2019).
The author state that in Serbia, as a developing country, National guidelines for practice
as well as the data on risk factors and incidence rate of PVC‐related local complications do not
exist. No set standards for PIVC systems are used .integrated PIVC systems are not always
available due to the high costs, scarcity of skin cleansing solutions and dressing and tape are
sporadically available. (Simin et al., 2019).
The aim of the study was to identify the occurrence of local PVC complications, incident,
severity, and risk factors. To achieve this the authors used three answerable questions
a. What are the incidence and type of local complications?
b. (b) What is the degree of their manifestations?
c. (c) What are patient‐related risk factors, the characteristics of PVC and the administered
therapy which may trigger complications? (Simin et al., 2019).
Methods (Design, Data Collection, and Data
Analysis)
This was an original article and the study was conducted as an observational perspective.
They are used to study causes of disease and are designed to test hypothesis about disease
etiology and prognosis. The exposures are never indiscriminately assigned The potential for bias
is higher in observational research but they are able to control cofounders using statistical
methods such as stratification and multivariate regression In epidemiology they assist to predict
future demands on the healthcare systems assisting in planning interventions (De Rango, 2016).
The methodology section does not clearly state whether the study was a quantitative or

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qualitative study however on analyzing the various instruments used for data collection and
analysis such as observational and document analysis, computational tools (SPSS Version 21).
Quantitative Data Collection
The data was collected through history taking of patient’s medical data, such as age,
gender body mass and previous PIVC use, comorbidities intravenous administration and presents
of wound drains and indwelling catheters. Cannula insertion and removal data were collected
from the Vein assessment tool (VAT) a quality assessment tool used by nurses to ’record cannula
data which includes the reason for placement site, size and skin condition. : A study carried out
in Queensland on cannula competent nurses validated The Vein Assessment Tool (VAT) and its
usefulness for research studies and clinical use. (Webster, Morris, Robinson, & Sanderson,
2007). Cannula monitoring data on the assessment of the PVC site was recorded by the
researcher daily, visual inspection and palpation for skin color change swelling and integrity of
the dressing. If swelling was detected a transparent mill metric ruler was used to measure the
diameter. The type of medications and solutions administered was collected from nurses and
medication charts daily. The severity of Infiltration was assessed using the infiltration scale and.
The visual infusion phlebitis scale was used to diagnose and classify phlebitis severity. The
infusion nurses society developed and were said to be valid easy to use and reliable (Groll,
Davies, Mac Donald, Nelson, & Virani, 2010). Pain assessment asking patient questions and
documentation of the Patient pain score using the numerical rating scale. A pilot study conducted
supported the validity and reliability of the pain assessment scale.
The researcher collected cannuala monitoring data daily and also collected data from
nurses who were responsible for the administration of intravenous therapy.

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The data collection procedures are adequately described such as the patient, medical data,
cannualation history, and commodities. However having the researchers present could introduce
influence resulting in bias .however the strength of this study is the use of instruments that have
been validated and their use also helps address cofounding variables (Greenhalgh, 2014).
The sampling method was representative of the wider population. The quantitative
prerequisite threshold number people were met although one healthcare centre was used. The
author states a sample size of 323 participates turned into determined statistically the use of the
confidence interval the margin of error of 5% and 95% confidence level and predicted proportion
of sufferers with PVC associated headaches at 30% This is a statistical check to decide the
sample size is big enough as a small pattern can be much less reliable due to chance variations
than a large look at (Aveyard & Sharp, 2013)The inclusion criteria had been sufferers eighteen
years and above indicated for intravenous remedy through PIVC lasting longer than 24 hours.
Qualitative Data Collection
The writer was guided by STROBE (Strengthening the Reporting of Observational
Studies in Epidemiology) which aims to provide a guide in conducting research reporting
outcomes.
The STROBE Statement consists of a checklist of 22 items, which relate to the title,
abstract, introduction, methods to help readers when c The author states that the strobe guidelines
for the research The STROBE Statement in part states “guidance to authors about how to
improve the reporting of observational studies and facilitates critical appraisal and interpretation
of studies by reviewers, journal editors …”. the STROBE Statement aims to provide helpful
recommendations for reporting observational studies in epidemiology .(von Elm et al.,
2014)critically appraising published articles(von Elm et al., 2014).

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Finally, the study was performed only in one clinic using 323 patients (Alspach, 2017;
Simin et al., 2019).for quantitative analysis, a large sample is required to produce reliable results.
Data Analysis
The Statistical Package for Social Sciences software package, version SPSS 25, was used
for statistical data processing. Numerical variables were supplied by using the use of
mathematics imply and measure of variability (standard deviation, range of values), while
characteristic variables were offered through the usage of incidence and percent. To take a look
at the distinction inside the incidence of characteristic values, the Pearson chi‐rectangular test
became used. Multivariate evaluation protected the software of the binary logistic regression
version, and the Wald check become used to interpret the significance of character coefficients in
the version and the percentages ratio (OR) together with the ninety five% self-belief interval
(CI). Values of p < zero.05 were taken as full-size.
Findings
The results of this study are clearly presented in great detail in tables which include the
characteristics of the participants, phlebitis and infiltration incidence and grade in relation to
patient and peripheral cannula characteristics.
Our look at well-knownshows almost congruent incidence of infiltration, occlusion, and
dislodgment of discovered PVCs with the average prevalence evaluation performed across
research by Helmet Many research, in addition to the prevailing have a look at, suggest that
sufferers elderly over 60 are extra at risk of phlebitis, although that distinction became now not
statistically vast (Cicolini, Bonghi, Di Labio, & Di Mascio, 2009; Do Rego Furtado, 2011a;

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Mestre Roca et al., 2012; Salgueiro‐Oliveira, Parreira, & Veiga, 2012; Uslusoy & Mete, 2008).
Aging reduces the immune
Identify any gaps or boundaries in the look at. The study became done handiest in a
single health facility, among patients who obtained intravenous antibiotics, which surely
included them from the onset of infection, but on the other hand, it moreover contributed to
chemical vein infection; additionally, the dominant use of adhesive tape has certainly made it
tough to assess the website of PVC.
In this study, the guidelines had been no longer made for destiny studies. Given that most
of the neighbourhood headaches are preventable, the administration of peripheral intravenous
therapy must be carefully taken into consideration on the subject of the recognized vulnerable
affected person agencies. Since it does not require additional charges but takes under
consideration the present day requirements, smaller gauge PVC catheters proved advanced, and
their administration in most patients may be taken into consideration rational.
However, the high prevalence of phlebitis and the presence of a medium and superior
stage of phlebitis advocate that it's far essential to bear in mind corrective measures that consist
of standardization (institutional and country wide) of approaches associated with PVC insertion,
as well as academic campaigns. Routine software of vein visualization sellers, PVC which
catheters are fabricated from substances which can be much less possibly to purpose infection
and transparent dressings require additional monetary resources. It is sincerely one of the
answers to growth the range of nurses and set up IV teams, even though; it calls for extra funding
and stakeholder engagement in the health coverage.
Conclusion of Article

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According to the article, the prevalence of infiltration, occlusion, and dislodgment is nearly
congruent with the average occurrence of preceding research. However, the incidence and degree of
severity related to the prevalence of phlebitis have been considerably higher.
Summary of strengths and weaknesses
The study become hardiest in one health facility, amongst patients who acquired intravenous
antibiotics, which truly protected them from the onset of contamination, however then again, it
additionally contributed to chemical vein inflammation; also, the dominant use of adhesive tape has
simply made it tough to evaluate the site of PVC.
The relevance of findings for practice
According to the articles and for the reason that most of the local headaches are
preventable, the administration of peripheral intravenous therapy should be carefully considered
in terms of the diagnosed inclined patient corporations. Since it does no longer require additional
fees however takes into consideration the current requirements, smaller gauge PVC catheters
proved superior, and their management in most patients can be considered rational.
However, the high occurrence of phlebitis and the presence of a medium and advanced
degree of phlebitis recommend that it's miles essential to bear in mind corrective measures that
consist of standardization (institutional and countrywide) of processes associated with PVC
insertion, in addition to instructional campaigns. Routine application of vein visualization sellers,
PVC which catheters are manufactured from materials which are much less possibly to cause
irritation and transparent dressings require extra financial sources. It is honestly one of the
answers to boom the wide variety of nurses and establish IV groups, though; it requires
additional funding and stakeholder engagement inside the health policy.

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Conclusion
The Serbian research was conducted at one clinic on 323 participates with a total of 1.428
cannulations against a national average of two and a Half million calculations. Including
recorded international cannulations of billion. It was not a wide range study.The author also
reveals discrepancies in the data collected that in some instances data on the intravenous therapy
administration cannot be claimed with certainty which medication or solution was administered
at the time of removal of the cannula due to poor documentation. (Simin et al., 2019). There
were difficulties adhering to the diagnostic criteria of phlebitis although nurses had been trained
in the use of diagnostic tool cannulas were not being removed even though two to three signs of
phlebitis were apparent. (Simin et al., 2019).

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