Peripheral intravenous catheter-induced phlebitis in a tertiary hospital of Karachi: a cohort study.

PURPOSE: This study aimed to determine the incidence of peripheral intravenous catheter (PIVC)-induced phlebitis and its predictors among adult patients hospitalized at Dow University Hospital, Karachi, Pakistan. METHODS: A sample of 258 adult patients admitted in the selected wards and planned for peripheral intravenous catheter insertion were recruited through consecutive sampling during March to May 2019. Daily follow-ups were performed to observe signs of phlebitis using a validated tool. The cohort was followed until discharge, removal of peripheral intravenous catheter, or study conclusion. RESULTS: Of 258 patients studied, 139 (53.9%) were females. A significant number of the participants 104 (40.3%) were young adults of age 20-40 years. The incidence of phlebitis was 39.1%. Tuberculosis (TB), peripheral intravenous catheter dwell time before initial assessment, administration of IV fluids, and dissatisfactory nursing care at Day 1 were associated significantly with the development of phlebitis. There was a doseresponse relationship between the catheter dwell time in hours before initial assessment and the development of phlebitis. CONCLUSION: This study found an increased incidence (39.1%) in three months of PIVC-induced phlebitis among adult patients. In addition to patient-related and PIVC-related risk factors considered in this study, PIVC-induced phlebitis is found to be significantly associated with the level of PIVC care provided by nurses. Continuous nursing education, developing standard care plans for PIVCs, and proper documentation of care are recommended.

Exploration of the Current State of Peripheral Intravenous Catheter Complications and Documentation: A Point Prevalence Study.

Peripheral intravenous catheters (PIVCs) are the most commonly used invasive devices in acute care hospitals, with nurses being primarily responsible for the insertion and care of these devices. This point prevalence study aimed to describe current PIVC status and nursing documentation in a large, regional health care system and to explore variables associated with PIVC complications. The study was conducted with adult inpatients. There were 665 PIVCs included in the study. Dressings were clean, dry, and intact in 83% of observations; only 2.7% did not have a transparent dressing. Thirty-one percent of PIVCs were inserted in areas of flexion. Median dwell time was 2.39 days (± 2.36 days), with upper arm sites having the longest dwell time. Overall inter-rater reliability (IRR) for an infiltration or phlebitis score of 0 was high (97.4% and 92%, respectively). However, overall agreement was only 77.16% for infiltration and 40.07% for phlebitis, with significant disagreement as scores increased. Study findings support that there was strong compliance with the Infusion Nurses Society's (INS) Infusion Therapy Standards of Practice vascular access practice recommendations; however, opportunities to improve infiltration/phlebitis assessment and documentation exist.

Peripheral Intravenous Catheter-Related Phlebitis and Infiltration in an Emergency Department: A Descriptive Study.

This study aims to analyze the incidences of peripheral intravenous catheter-related phlebitis and infiltration and the associated risk factors in emergency departments. This descriptive cross-sectional, nonexperimental study was conducted with 300 participants in the emergency department of a university hospital in Türkiye between January 15 and February 15, 2018. The incidence of peripheral intravenous catheter-related phlebitis was 31%, which was grade 1 in 29.7% and grade 2 in 1.3% of the emergency department participants. Additionally, the incidence of peripheral intravenous catheter-related infiltration was 55.4%, including grades 1, 2, and 3 in 36.0%, 12.7%, and 6.7% of the participants, respectively. Incidences of phlebitis and infiltration were related to age, duration of peripheral intravenous catheterization longer than 24 hours, and repeated use of the catheter insertion site. The findings of this study may draw attention to the factors that trigger phlebitis and infiltration due to peripheral intravenous catheter insertions in the emergency department and may guide practices to prevent these complications before they develop. In this context, the Phlebitis Scale and Infiltration Scale developed by the Infusion Nurses Society are recommended to be used in the emergency department.

Complications after peripherally inserted central catheter versus central venous catheter implantation in intensive care unit: propensity score analysis using a nationwide database.

BACKGROUND: It remains unclear whether peripherally inserted central catheters (PICCs) are superior to central venous catheters (CVCs); therefore, we compared post-implantation complications between CVC and PICC groups. RESEARCH DESIGN AND METHODS: Patients who received CVCs or PICCs between April 2010 and March 2018 were identified from the Diagnosis Procedure Combination database, a national inpatient database in Japan. The outcomes of interest included catheter infection, pulmonary embolism, deep vein thrombosis, and phlebitis. Propensity score overlap weighting was used to balance patient backgrounds. Outcomes were compared using logistic regression analyses. RESULTS: We identified 164,185 eligible patients, including 161,605 (98.4%) and 2,580 (1.6%) in the CVC and PICC groups, respectively. The PICC group was more likely to have overall complications (odds ratio [OR], 1.70; 95% confidence interval [CI], 1.32-2.19), pulmonary embolism (OR, 2.32; 95% CI, 1.38-3.89), deep vein thrombosis (OR, 1.86; 95% CI, 1.16-2.99), and phlebitis (OR, 1.72; 95% CI, 1.27-2.32) than the CVC group. There was no significant intergroup difference in catheter infection (OR, 1.09; 95% CI, 0.39-3.04). CONCLUSIONS: Patients with PICCs had a significantly greater incidence of complications than did those with CVCs. Further research is necessary to explore the factors contributing to these complications.

Effectiveness and Safety of Measures to Prevent Infections and Other Complications Associated With Peripheral Intravenous Catheters: A Systematic Review and Meta-analysis.

BACKGROUND: Peripheral intravenous catheters (PIVCs) contribute substantially to the global burden of infections. This systematic review assessed 24 infection prevention and control (IPC) interventions to prevent PIVC-associated infections and other complications. METHODS: We searched Ovid MEDLINE, Embase, Cochrane Library, WHO Global Index Medicus, CINAHL, and reference lists for controlled studies from 1 January 1980-16 March 2023. We dually selected studies, assessed risk of bias, extracted data, and rated the certainty of evidence (COE). For outcomes with 3 or more trials, we conducted Bayesian random-effects meta-analyses. RESULTS: 105 studies met our prespecified eligibility criteria, addressing 16 of the 24 research questions; no studies were identified for 8 research questions. Based on findings of low to high COE, wearing gloves reduced the risk of overall adverse events related to insertion compared with no gloves (1 non-randomized controlled trial [non-RCT]; adjusted risk ratio [RR], .52; 95% CI, .33-.85), and catheter removal based on defined schedules potentially resulted in a lower phlebitis/thrombophlebitis incidence (10 RCTs; RR, 0.74, 95% credible interval, .49-1.01) compared with clinically indicated removal in adults. In neonates, chlorhexidine reduced the phlebitis score compared with non-chlorhexidine-containing disinfection (1 RCT; 0.14 vs 0.68; P = .003). No statistically significant differences were found for other measures. CONCLUSIONS: Despite their frequent use and concern about PIVC-associated complications, this review underscores the urgent need for more high-quality studies on effective IPC methods regarding safe PIVC management. In the absence of valid evidence, adherence to standard precaution measures and documentation remain the most important principles to curb PIVC complications. CLINICAL TRIALS REGISTRATION: The protocol was registered in the Open Science Framework (https://osf.io/exdb4).

Phlebitis in Medical-Surgical Units: A Case-Control Study in a Brazilian Hospital.

The most commonly used vascular access is the peripheral intravenous catheter (PIVC). However, it can trigger complications and the occurrence of adverse events, such as phlebitis. This study evaluated the variables that are associated with the occurrence of phlebitis in medical and surgical inpatient units. This is an observational, retrospective, case-control study in medical and surgical hospitalization units of a private general hospital in the city of São Paulo. Participants were an average age of 66.3 years, and 71% were hospitalized in medical units. The risk variables associated with phlebitis were medical hospitalization (odds ratio [OR] = 4.36; P = .002), presence of comorbidity (OR = 10.73; P < .001), and having 5 or more PIVCs (OR = 53.79; P = .001). Regarding intravenous therapy, the use of contrast was a risk variable (OR = 2.23; P = .072). On the other hand, patient education regarding PIVCs was a protective measure against the development of phlebitis. The nursing team plays an essential role in the care of patients with PIVCs, inpatient guidance, planning, and device choice, taking into account the risk factors for phlebitis to maintain the preservation of vascular health and reduce adverse events.

Prevalence, Clinical and Imaging Characteristics of Superior Ophthalmic Vein Periphlebitis in Thyroid Eye Disease.

PURPOSE: To determine the prevalence, clinical features, and radiographic findings of superior ophthalmic vein periphlebitis (SOVP) in thyroid eye disease (TED). METHODS: Patients with a clinical diagnosis of thyroid eye disease and contrast-enhanced imaging were included. Imaging was reviewed for the presence of SOVP, and patients with SOVP were compared to those without. A random eye was determined to be the affected eye in patients without SOVP. RESULTS: A total of 212 patients met the inclusion criteria. Unilateral SOVP was identified in 4.7% of cases. There was no significant difference in age ( p = 0.22), gender ( p = 0.09), or disease duration ( p = 0.14) between patients with and without SOVP. There was a significant ( p < 0.05) difference in stage classification and clinical activity core between the groups. The affected eye in patients with SOVP had significantly ( p < 0.05) greater margin reflex distance 1, degree of relative proptosis, horizontal motility restriction, and vertical motility restriction than in patients without SOVP. There was no significant difference in horizontal strabismus ( p = 1.0), vertical strabismus ( p = 0.87), or relative intraocular pressure ( p = 0.77). On imaging, the maximal diameter of the SR and IR were found to be significantly ( p < 0.05) larger in the affected eye of patients with periphlebitis; however, there was no difference in measured diameter of the medial rectus and ( p = 0.30) or lateral rectus ( p = 0.78). CONCLUSIONS: SOVP is an under-reported imaging finding of thyroid eye disease. It is associated with significantly greater margin reflex distance 1, relative proptosis, and motility restriction on exam as well as larger superior rectus and inferior rectus diameter on imaging. These patients tend to present in the active stage of disease with greater clinical activity score.

Uso de catéteres venosos de línea media en pacientes hospitalizados / The use of venous catheters of average line in hospitalized patient

En el contexto actual en el que han surgido numerosas alternativas en terapia intravenosa, se hacen necesarios estudios sobre los diferentes dispositivos disponibles para determinar cuál es el sistema más idóneo en cada caso. Las líneas medias surgen como alternativa a la utilización de catéteres venosos periféricos y catéteres centrales de inserción periférica. El objetivo de este estudio es evaluar el uso de los catéteres de línea media en pacientes hospitalizados. Método: Estudio retrospectivo de 1016 pacientes. Se analizaron variables relacionadas con el tiempo medio de utilización del catéter, la tasa de incidencias para cada una de las complicaciones, el número de catéteres retirados y sus causas. Resultados: El 40 % de los catéteres se canalizó por mal acceso venoso del paciente (406), el 42% por tratamiento intravenoso largo (427) y el 18% por tratamiento irritante (183). Respecto a la efectividad de los catéteres, el tiempo medio de utilización fue de 12.1 días (DE 9.4). Finalizaron el tratamiento 854 pacientes, 704 (69.3%) por fin de tratamiento y 150 (14.8%) por fallecimiento. Presentaron complicaciones el 7.4 % de los pacientes (75). Se retiraron por mal funcionamiento del catéter el 4.4% (45), el 1% por complicaciones del paciente (10). El 2% de los catéteres se retiró por fiebre (20). Conclusiones: El catéter de línea media es un dispositivo de acceso venoso con una baja tasa de complicaciones, presenta un tiempo medio de permanencia en torno a los 12 días. Supone una alternativa a los catéteres periféricos cortos en pacientes con mal acceso venoso y ofrece una alternativa a las rotaciones frecuentes en pacientes con tratamientos antibióticos superiores a 7 días

In the current context in which numerous alternatives have emerged in intravenous therapy, studies are needed on the different devices available to determine which is the most suitable system in each case. The midlines arise as an alternative to the use of peripheral venous catheters and central peripheral insertion catheters. The main objective of this study is to evaluate the use of midline catheters in hospitalized patients. Method: Retrospective study of 1016 patients. We analyzed variables related to the mean time of catheter use, the incidence rate for each of the complications, the number of catheters removed and their causes. Results: 46.5% of the catheters were inserted in men (472). The average age was 65 years (SD 16.8), being the youngest of 14 and the oldest of 101 years. 40% of the catheters were channeled due to poor venous access of the patient (406), 42% for long intravenous treatment (427) and 18% for irritant treatment (183). Regarding the effectiveness of the catheters, the average time of use was 12.1 days (SD 9.4). The treatment was terminated by 854 patients, 704 (69.3%) by the end of treatment and 150 (14.8%) by death. 7.4% of patients presented complications (75). 4.4% (45) were removed due to malfunction of the catheter, 1% due to patient complications (10). 2% of the catheters were removed due to fever (20). Conclusions: The middle line catheter is a venous access device with a low complication rate, it has a average residence time of around 12 days. It is an alternative to short peripheral catheters in patients with poor vein access and offers an alternative to frequent rotations in patients with antibiotic treatments longer than 7 days

Notificação de eventos adversos: caracterização dos eventos ocorridos em um complexo hospitalar / Notificación de eventos adversos: caracterización de los eventos ocurridos en un complejo hospitalario / Notifications of adverse events: characterization of the events that occurred in a hospital complex

Resumo OBJETIVO Analisar as notificações de incidentes relacionados à segurança do paciente. MÉTODOS Estudo transversal com abordagem quantitativa, baseado nos dados do Gerenciamento de Risco de um complexo hospitalar, localizado no noroeste paulista, de agosto/2015 a julho/2016. RESULTADOS Foram analisadas 4.691 notificações. O enfermeiro foi a categoria profissional que mais notificou (71%), seguido do médico (8%). O período mais frequente em que ocorreram as notificações foi o diurno. Houve diferença significativa da proporção de notificações entre os dias da semana. As notificações foram classificadas por motivo, com destaque para os medicamentos (17%), seguido de lesões de pele (15%) e flebite (14%). A maior frequência de notificações ocorreu nas unidades de Internação. Quanto à gravidade 344 eventos ocasionaram dano ao paciente, sendo a maioria de intensidade leve (65%). CONCLUSÃO As notificações espontâneas são uma importante fonte de informações e evidenciam a magnitude do problema relacionado aos incidentes em saúde.

Resumen OBJETIVO Analizar las notificaciones de incidentes relacionados con la seguridad del paciente. MÉTODOS Estudio transversal con abordaje cuantitativo, basado en los datos del Gestión de Riesgos de un complejo hospitalario, ubicado em el noroeste paulista, de agosto de 2015 a julio de 2016. RESULTADOS Se analizaron 4.691 notificaciones. El enfermero fue la categoría profesional que más notificó (71%), seguido del médico (8%). El período más frecuente en que ocurrieron las notificaciones fue el diurno. Hubo una diferencia significativa de la proporción de notificaciones entre los días de la semana. Las notificaciones se clasificaron por motivo, con destaque para los medicamentos (17%), seguido de lesiones de piel (15%), flebitis (14%). La mayor frecuencia de notificaciones ocurrió en las unidades de Internación. En cuanto a la gravedad 344 eventos ocasionaron daño al paciente, siendo la mayoría de intensidad leve (65%). CONCLUSIÓN Las notificaciones espontáneas son una importante fuente de información, y evidencia la magnitud del problema relacionado con los incidentes en salud.

Abstract OBJECTIVE Analyze incident notifications related to the patient's safety. METHOD Cross-sectional study with quantitative approach, based on data from the risk Management of a hospital complex, located in northwest São Paulo, from August 2015 to July 2016. RESULTS 4,691 notifications were analyzed. Nurses were the professionals who notified the most (71%), followed by physicians (8%). The most frequent period in which the notifications occurred was the daytime. There was significant difference in the proportion of notifications between the days of the week. The notifications were classified by reason and the most prevalent were those related to medication (17%), followed by skin lesions (15%), and phlebitis (14%). The highest frequency of notifications occurred in the hospitalization units. In relation to severity, 344 events caused damage to the patient, most of which were of mild intensity (65%). CONCLUSION Spontaneous notifications are an important source of information, and highlight the magnitude of the problem related to health incidents.

Complicações locais da terapia intravenosa periférica e fatores associados / Complicaciones locales de la terapia intravenosa periférica y factores asociados / Local complications of peripheral intravenous therapy and associated factors

RESUMO Introdução: A Terapia Intravenosa configura-se em importante procedimento terapêutico e diagnóstico, amplamente utilizada pela Enfermagem no cuidado hospitalar. Esse procedimento possui elevado risco em curto prazo, bem como a possibilidade de agravos secundários ligados as complicações derivadas dessa terapia. Objetivo: Identificar a prevalência e os fatores associados às complicações locais da terapia intravenosa periférica em pacientes institucionalizados em um setor de neurologia e clínica médica de um hospital público de ensino. Métodos: Trata-se de um estudo transversal, exploratório e descritivo de abordagem quantitativa, com observação sistemática e busca em dados secundários disponíveis em prontuário de 63 pacientes institucionalizados num hospital público de ensino. Os dados foram coletados de janeiro a março de 2015 e submetidos a tratamento estatístico por meio do programa Statistical Package of Social Sciences, versão 19.0. Resultados: A prevalência de flebite foi de 25,4 porcento, infiltração de 15,9 porcento e 11,1 porcento de hematoma. A maioria dos pacientes do estudo encontrava-se em terapia no intervalo máximo de 48 horas. No momento da observação, os cateteres estavam em sua maioria conectados ao polifix (n=58; 92,1 porcento). Quanto aos sintomas identificou-se edema, dor, desconforto e eritema ao redor da inserção do cateter em 16 (25,4 porcento) dos participantes. Conclusão: A prevalência de complicações da terapia intravenosa foi elevada, com destaque para a flebite, infiltração e hematoma. Houve diferenças entre as taxas de prevalência por clinicas, relacionadas ao intervalo de trocas, e ao tipo de cateter periférico inserido(AU)

RESUMEN Introducción: La terapia intravenosa es un importante procedimiento terapéutico y diagnóstico, ampliamente utilizado por la enfermería en la atención hospitalaria. Este procedimiento tiene un alto riesgo a corto plazo y la posibilidad de complicaciones relacionadas con problemas de salud secundarios derivados de esta terapia. Objetivo: Identificar la prevalencia y los factores asociados con complicaciones locales de la terapia intravenosa periférica en pacientes institucionalizados en un departamento de neurología clínica y clínica médica de un hospital público de enseñanza. Métodos: Estudio transversal, exploratorio y descriptivo, de enfoque cuantitativo, con observación sistemática y búsqueda en los datos secundarios disponibles en las historias clínicas de 63 pacientes institucionalizados en un hospital público de enseñanza. Los datos fueron recogidos de enero a marzo 2015 y sometidos a análisis estadístico utilizando el paquete estadístico para las ciencias sociales, versión 19.0. Resultados: La prevalencia de flebitis fue de 25,4 por ciento, la infiltración del 15,9 por ciento y el hematoma de 11,1 por ciento. La mayoría de los pacientes del estudio se encontraba en terapia en el intervalo máximo de 48 horas. En el momento de la observación, los catéteres fueron en su mayoría conectados con polifix (n = 58; 92,1 por ciento). Se identificó edema, dolor, malestar y eritema alrededor de la inserción del catéter en 16 (25,4 por ciento) de los participantes. Conclusiones: La prevalencia de complicaciones de la terapia intravenosa fue alta, especialmente flebitis, infiltración y hematoma. Hubo diferencias entre las tasas de prevalencia de las clínicas, en relación con el intervalo de cambio y tipo de catéter periférico(AU)

ABSTRACT Introduction: The Intravenous Therapy sets in important therapeutic and diagnosis procedure, widely used by nursing profesionals in a hospital care. This procedure has a high risk in short term and the possibility of secondary complications related to health problems derived from this therapy. Objective: To identify the prevalence and associated factors to local complications of peripheral intravenous therapy in patients institutionalized in a medical clinic and neurological department of a public teaching hospital. Methods: This is a cross-sectional, exploratory and descriptive study, with a quantitative approach with systematic observation and search on secondary data, available in the medical records of 63 patients institutionalized in a public teaching hospital. Data were collected from January to March 2015 and submitted to statistical analysis using the Statistical Package for the Social Sciences, version 19.0. Results: The prevalence of phlebitis was 25.4 percent, of infiltration 15.9 percent and 11.1 percent of hematoma. Most patients in the study were in therapy at the maximum interval of 48 hours. At the time of observation, the catheters were mostly connected to polifix (n = 58; 92.1 percent). Regarding specific symptoms were identified edema, pain, discomfort and erythema around the catheter insertion in 16 (25.4 percent) participants. Conclusion: The prevalence of complications of intravenous therapy was high, especially phlebitis, infiltration and hematoma. There were differences between the prevalence rates for clinics, related to the exchange intervals, and type of peripheral inserted catheter(AU)

Complicaciones derivadas de la inserción periférica de catéter central con punción ciega o ecoguiada / Complications derived of Peripherally-Inserted Central Catheters with blind or ultra-sound guided puncture

OBJETIVO: determinar la influencia de la técnica de colocación de catéteres centrales de inserción periférica (PICC), ecoguiada frente a punción ciega, sobre la incidencia de flebitis y otras complicaciones en pacientes oncológicos. MÉTODO: estudio analítico observacional de cohorte retrospectivo (grupo punción ciega versus grupo con técnica ecoguiada). Se incluyeron, 168 pacientes a los que se les colocó un PICC durante los años 2013 a 2015 (seleccionados por muestreo aleatorio simple), con punción ciega (n= 114) o ecoguiada (n= 54) en el Hospital de Día del ICO-Hospital Duran I Reynals (Barcelona). Las variables estudiadas fueron la incidencia de flebitis y otras complicaciones asociadas al catéter, el tiempo hasta la aparición de las complicaciones, el motivo de retirada y el tiempo de duración del catéter. RESULTADOS: la edad media de los pacientes en ambos grupos fue similar (59,3 en grupo punción ciega y 59,7 años en grupo con técnica ecoguiada). El tumor más habitual fue el cáncer de cabeza y cuello, aunque con diferencias significativas en la distribución de los mismos entre ambos grupos. La flebitis fue la complicación más incidente. Ocurrió en el 16,7% del grupo con punción ciega frente al 1,8% en colocación ecoguiada (RR= 0,11; p= 0,012). La flebitis apareció de media a los 30 días (DE: 6,93) en los catéteres ecoguiados y a los 11 días (DE: 8,58) en los insertados sin ecógrafo (p= 0,002). CONCLUSIONES: la implantación de la técnica ecoguiada para la inserción de PICC frente a la punción ciega se asocia a una reducción en la incidencia y en el tiempo de aparición de la flebitis

OBJECTIVE: to determine the impact of the ultrasound-guided technique for peripherally-inserted central catheters (PICCs) vs. blind puncture, on the incidence of phlebitis and other complications in oncology patients. METHOD: an observational, analytical, retrospective cohort study (blind puncture arm vs. arm with ultrasound-guided technique). The study included 168 patients with a PICC inserted from 2013 to 2015 (selected through simple random sampling), with blind (n= 114) or ultrasound-guided puncture (n= 54) at the Day Hospital of the ICO-Hospital Duran I Reynals (Barcelona). The variables studied were: incidence of phlebitis and other catheter-related complications, time until the development of complications, reason for removal, and time of catheter duration. RESULTS: the mean age of patients in both arms was similar (59.3 years in the blind puncture arm and 59.7 years in the arm with ultrasound-guided technique). The most frequent tumour was head and neck, though with significant differences in distribution between both arms. Phlebitis was the complication with the highest incidence, which occurred in 16.7% of the blind puncture arm vs. 1.8% with ultrasound-guided insertion (RR= 0.11; p= 0.012). The mean time for phlebitis development was 30 days (SD: 6.93) for ultrasound-guided catheters, and 11 days (SD: 8.58) for those inserted without ultrasound (p= 0.002). CONCLUSIONS: the implementation of the ultrasound-guided technique for PICC insertion vs. blind puncture was associated with a reduction in the incidence of phlebitis and the time to its development

Incidência de flebites em pacientes adultos / Incidence of phlebitis in adult patients

Objetivo: verificar a incidência de flebites em pacientes adultos associando com característica sociodemográfica, internação hospitalar e punção venosa. Método: estudo quantitativo, descritivo, retrospectivo, realizado em um hospital da rede sentinela, por meio da notificação de eventos adversos no prontuário eletrônico, totalizando 176. Foram calculados a média e o desvio padrão para as variáveis quantitativas. A incidência de flebites foi calculada usando-se números absolutos e porcentagem. Parecer 1.050.829. Resultados: a incidência média de flebite foi 14,66 em 12 meses. A maioria dos pacientes era de homens, entre 61 e 80 anos, branca, casada, com ensino fundamental incompleto, aposentada, católica, do Sistema Único de Saúde, com internação <15 dias e punção venosa periférica com tempo <72h de inserção. A maioria dos enfermeiros não especificou a droga prescrita. Conclusão: a flebite ocorreu em pacientes com tempo de internação <15 dias e punção venosa <72h. A maioria das drogas não foi especificada, mas, quando descrita, era irritante. A conduta foi a retirada e a troca da punção e os pacientes receberam alta hospitalar. Este estudo demonstrou a necessidade da notificação correta de flebite pelos enfermeiros a fim de avaliar os riscos para melhorar a segurança do paciente.(AU)

Phlebitis and infiltration: vascular trauma associated with the peripheral venous catheter / Flebite e infiltração: traumas vasculares associados ao cateter venoso periférico / Flebitis e infiltración: traumas vasculares asociados al catéter venoso periférico

ABSTRACT Objective: to determine the incidence rate and risk factors for the nursing-sensitive indicators phlebitis and infiltration in patients with peripheral venous catheters (PVCs). Method: cohort study with 110 patients. Scales were used to assess and document phlebitis and infiltration. Socio-demographic variables, clinical variables related to the PVC, medication and hospitalization variables were collected. Descriptive and inferential analysis and multivariate logistic models were used. Results: the incidence rate of phlebitis and infiltration was respectively 43.2 and 59.7 per 1000 catheter-days. Most PVCs with these vascular traumas were removed in the first 24 hours. Risk factors for phlebitis were: length of hospital stay (p=0.042) and number of catheters inserted (p<0.001); risk factors for infiltration were: piperacillin/tazobactan (p=0.024) and the number of catheters inserted (p<0.001). Conclusion: the investigation documented the incidence of nursing-sensitive indicators (phlebitis and infiltration) and revealed new risk factors related to infiltration. It also allowed a reflection on the nursing care necessary to prevent these vascular traumas and on the indications and contraindications of the PVC, supporting the implementation of the PICC as an alternative to PVC.

RESUMO Objetivo: determinar a taxa de incidência e os fatores de risco para os indicadores sensíveis aos cuidados de Enfermagem, flebite e infiltração, em pacientes portadores de cateteres venosos periféricos (CVPs). Método: estudo de coorte com 110 pacientes. Utilizou-se escalas para avaliar e documentar flebite e infiltração. Recolheram-se variáveis sociodemográficas, clínicas, relativas ao CVP, à medicação e à internação, bem como efetuou-se análise descritiva e inferencial, e modelação logística multivariada. Resultados: a taxa de incidência de flebite e infiltração foi de 43,2 e 59,7 por mil cateteres-dia, respectivamente. A maioria dos CVPs foi removida nas primeiras 24h devido a esses traumas vasculares. Foram fatores de risco para flebite o tempo de internação (p=0,042) e o número de cateteres inseridos (p<0,001), sendo para infiltração a piperacilina/tazobactan (p=0,024) e o número de cateteres inseridos (p<0,001). Conclusão: a investigação documentou a incidência de indicadores sensíveis aos cuidados de Enfermagem (flebite e infiltração) e evidenciou novos fatores de risco relacionados à infiltração. Possibilitou, também, uma reflexão sobre os cuidados de Enfermagem para prevenir esses traumas vasculares, as indicações e as contraindicações do CVP, tendo subsidiada a implementação do PICC nas práticas de Enfermagem como alternativa ao CVP.

RESUMEN Objetivos: determinar la tasa de incidencia y los factores de riesgo para los indicadores sensibles a los cuidados de Enfermería, flebitis e infiltración, en pacientes portadores de catéteres venosos periféricos (CVPs). Método: se trata de un estudio de cohorte entre 110 pacientes. Se utilizaron escalas para evaluar y documentar la flebitis y la infiltración. Se recogieron variables sociodemográficas y clínicas, relativas al CVP, a la medicación y a la internación. Se realizó un análisis descriptivo e inferencial, y modelación logística multivariada. Resultados: la tasa de incidencia de flebitis e infiltración fue de 43,2 y 59,7 por mil catéteres-día, respectivamente. Se removió la mayoría de los CVPs en las primeras 24 horas debido a dichos traumas vasculares. Los factores de riesgo para la flebitis fueron: el tiempo de internación (p=0,042) y el número de catéteres insertados (p<0,001); para la infiltración: la piperacilina/tazobactan (p=0,024) y el número de catéteres insertados (p<0,001). Conclusión: la investigación documentó la incidencia de indicadores sensibles a los cuidados de Enfermería (flebitis e infiltración) y evidenció nuevos factores de riesgo relacionados con la infiltración. Posibilitó, también, una reflexión sobre los cuidados de Enfermería para prevenir los traumas vasculares y sobre las indicaciones y contraindicaciones del CVP, con la implantación del PICC auxiliando en las prácticas de Enfermería como alternativa del CVP.

Incidencia y factores de riesgo de flebitis asociadas a catéteres venosos periféricos / Incidence and risk factors of phlebitis associated to peripheral intravenous catheters

OBJETIVO: Determinar la incidencia de flebitis y los factores de riesgo relacionados con el cuidado de los catéteres venosos periféricos (CVP). MÉTODO: Estudio de cohortes prospectivo en el Hospital Universitario Central de Asturias. Se incluyeron 178CVP que fueron observados diariamente hasta su retirada. La ocurrencia de flebitis fue medida con la escala visual de flebitis por infusión, que permite distinguir entre gradoI (posible flebitis) y gradoII (flebitis). También se recogió el diagnóstico de flebitis que realizó de forma independiente el personal de enfermería de las unidades. Por último, se obtuvo información sobre la inserción y el cuidado del CVP. Se calculó la incidencia de flebitis y la validez de los diagnósticos realizados en la unidad y, mediante regresión logística, se identificaron los factores de riesgo de flebitis. RESULTADOS: El 5,6% de los CVP presentaron flebitis, el 21,3% posibles flebitis y el 11,2% flebitis según el criterio del personal enfermero. La sensibilidad de los profesionales para diagnosticar flebitis fue del 100%, la especificidad, del 94%, y el valor predictivo positivo, del 50%. Después de controlar los potenciales confusores, la utilización de alargadera como accesorio del CVP incrementó el riesgo de flebitis (odds ratio: 4,8; p = 0,04) e insertar un catéter de calibre 22/24 gauges lo disminuyó (odds ratio: 0,2; p = 0,02). CONCLUSIONES: La falta de consenso sobre el diagnóstico de la flebitis dificulta su valoración por parte de los profesionales. Para minimizar la incidencia de flebitis sería aconsejable elegir el calibre de CVP más pequeño posible y evitar el uso de alargaderas como accesorio

OBJECTIVE: To determine the incidence and risk factors of phlebitis associated to the care of peripheral vascular catheters (PVC). Method: Prospective cohort study at the Central University Hospital of Asturias (Spain). A total of 178PVC were observed daily until their extraction. The incidence of phlebitis was measured using the Visual Infusion Phlebitis Scale, that distinguishes between gradeI (possible phlebitis) andII (phlebitis). The independent diagnoses of phlebitis made by staff nurses were also collected. Finally, data about the insertion and the care of the PVC was also obtained. The incidence of phlebitis and the validity of the diagnoses made by staff nurses were calculated and the risk factors of phlebitis were determined by means of logistic regression. RESULTS: 5.6% of the PVC presented phlebitis, 21.3% possible phlebitis and 11.2% had phlebitis according to nurses' criteria. The staff nurses had a sensitivity of 100%, a specificity of 94% and a positive predictive value of 50% in the diagnosis of phlebitis. After adjusting for potential confounders, the use of an extension tube as an accessory of the PVC was an independent predictor of phlebitis (odds ratio: 4.8; P=.04), but a PVC size of 22/24 gauges was associated with lower phlebitis incidence (odds ratio: 0.2; P=.02). CONCLUSIONS: Clinical phlebitis assessment is difficult because the agreement for phlebitis diagnosis is low. To minimize the incidence of phlebitis would be recommended to choose the smallest PVC size possible and to avoid using an extension tube as an accessory of the PVC

Incidencia de flebitis asociada a catéteres centrales de inserción periférica en UCI adultos: implementación de un protocolo para enfermería / Phlebitis incidence associated to peripherally inserted central catheters in adults ICU: implementation of a nursing protocol

Justificación: La flebitis es una de las complicaciones mas frecuentes de los Catéteres Centrales de Inserción Periférica. La evidencia científica sobre la utilidad de las escalas de medición para el diagnostico de flebitis es escasa. Objetivos: Comparar la incidencia de flebitis antes y después de la implementación de un protocolo. Material y métodos: Estudio de cohortes retrospectivo en 159 pacientes ingresados en UCI, a los que se les ha colocado un PICC, en dos periodos equivalentes de dos años consecutivos, Periodo 1 (n=59); frente a un grupo del Periodo 2 (n=100) en el que se aplicó un nuevo protocolo para el diagnóstico y manejo de flebitis (definición de flebitis, aplicación de la Visual Infusion Phlebitis Score y valoración continua). Resultados: El riesgo de ser diagnosticado de flebitis fue significativamente menor en el P2 (OR: 0.09, I.C.95% 0.01-0.52) Conclusiones: La incorporación del protocolo redujo un 90% los diagnósticos de flebitis (AU)

Phlebitis incidence related to peripherally inserted central catheters (PICCs): New nursing protocol application. Phlebitis is one of the most common complications of peripherally inserted central catheters (PICCs). The scientific evidence about the utility of measuring scales to phlebitis diagnosis is very limited. Objectives: To compare phlebitis incidence rate before and after the introduction of a new protocol. Materials and Methods: Retrospective cohort study in 159 patients admitted to the intensive care unit (ICU) for two years. First we assess phlebitis in 59 patients (group 1). After that we apply a new protocol to identify phlebitis with visual score and continuous evaluation to 100 patients (group 2) Results: The probability of being diagnosed of phlebitis is significantly smaller in intervention group (OR: 0.09; 95% C.I.: 0.02-0.57). Conclusions: Protocol application reduced the diagnosis of phlebitis in 90% (AU)

Incidência de flebite e flebite pós-infusional em adultos hospitalizados / Incidencia de flebitis y flebitis después de la infusión en adultos hospitalizados / Incidence of phlebitis and post-infusion phlebitis in hospitalised adults

RESUMO Objetivo Avaliar a incidência de flebite durante o uso de cateter intravenoso periférico (CIP) e pós-infusional e analisar a associação com fatores de risco em pacientes hospitalizados. Método Estudo de coorte com 165 pacientes adultos internados em hospital universitário de Porto Alegre que totalizaram 447 acessos no período de dezembro 2014 a fevereiro 2015. A coleta dos dados foi diária, e a análise dos dados ocorreu pela estatística descritiva e analítica. Resultados A incidência de flebite durante o uso do CIP foi de 7,15% e de flebite pós-infusional, 22,9%. A flebite durante o uso do cateter associou-se com a Amoxicilina + Ácido Clavulânico. A flebite pós-infusional apresentou associação do grau de gravidade com a idade e com o uso de Amoxacilina + Ácido Clavulânico, Cloridrato de Tramadol e Anfotericina. Conclusão A incidência de flebite pós-infusional mostrou-se um indicador importante para a análise do cenário da qualidade da assistência em saúde.

RESUMEN Objetivo Evaluar la incidencia de flebitis en el uso de catéter periférico intravenoso (CIP) y posinfusional y analizar la asociación con los factores de riesgo en pacientes hospitalizados. Método Estudio de cohorte con 165 pacientes adultos ingresados en un hospital universitario de Porto Alegre, que ascendió a 447 accesos de diciembre 2014 a febrero de 2015. La recolección de datos fue diaria y el análisis de datos fue mediante estadística descriptiva y analítica. Resultados La incidencia de flebitis durante el uso de catéter periférico intravenoso fue del 7,15% y de la flebitis posinfusional fue del 22,9%. La flebitis durante el uso del catéter se asoció con el uso de Amoxicilina + Ácido clavulánico. La flebitis posinfusional presentó una asociación del grado de gravedad con la edad, y con el uso de Amoxicilina + Ácido clavulánico, Clorhidrato de tramadol y Anfotericina. Conclusión La incidencia de flebitis posinfuncional mostró ser un indicador importante para el análisis del escenario de la calidad de atención en salud.

ABSTRACT Objective to determine the incidence of phlebitis during and after the use of peripheral intravenous catheter (PIC), and analyse the association of this complication with risk factors. Methods cohort study with 165 adult patients admitted to a university hospital in Porto Alegre, totalling 447 accesses, from December 2014 to February 2015. Data were collected on a daily basis and analysed by means of descriptive and analytical statistics. Results The incidence of phlebitis during PIC was 7.15% and the incidence of post-infusion phlebitis was 22.9%. Phlebitis during catheter use was associated with the use of Amoxicillin + Clavulanic Acid. The grade of post-infusion phlebitis was associated with age and use of Amoxicillin + Clavulanic Acid, Tramadol Hydrochloride, and Amphotericin. Conclusion The incidence of post-infusion phlebitis proved to be an important indicator to analyse the quality of the healthcare setting.

Fatores de risco para o desenvolvimento da flebite: revisão integrativa da literatura / Los factores de riesgo para el desarrollo de flebitis: revisión integrativa de la literatura / Risk factors for the development of phlebitis: an integrative review of literature

Resumo OBJETIVO Descrever as evidências científicas publicadas na literatura acerca dos fatores de risco para o desenvolvimento das flebites. MÉTODO Revisão integrativa da literatura com inclusão de 14 artigos originais encontrados nas bases LILACS, Scielo e Pubmed de janeiro de 2004 a abril de 2015 e analisados quanto ao nível de evidência e frequência, fatores associados, grau e tratamento das flebites. RESULTADOS A frequência/incidência/taxa mínima de flebite foi 3% e a máxima foi 59,1%. A maioria dos artigos (57,14%) relataram associação da flebite com fatores de risco, dentre eles, o tempo de permanência, local de punção e/ou região anatômica, tempo de internação, quantidade de acessos, motivo de retirada, sexo, antibióticos, manutenção intermitente e inserção de emergência. CONCLUSÕES Identificou-se a necessidade uniformização da quantificação deste evento e uma baixa consonância entre os fatores de risco associados a flebites. Outros estudos necessitam ser desenvolvidos para o real entendimento deste agravo no cotidiano hospitalar.

Resumen OBJETIVO Describir las evidencias científicas publicadas en la literatura sobre los factores de riesgo para el desenvolvimiento de las flebitis. MÉTODO Revisión integradora con la inclusión de 14 artículos originales se encuentran en el LILACS, SciELO y PubMed desde enero 2004 hasta abril 2015 y se analizaron para el nivel de evidencia y la frecuencia, factores asociados, el grado y el tratamiento de flebitis. RESULTADOSLa frecuencia/incidencia/ tasa mínima de flebitis fue del 3% y el máximo fue de 59,1%. La mayoría de los artículos (57,14%) reportaron asociación de la flebitis con los factores de riesgo, entre ellos la duración de la estancia, el sitio de punción y/o región anatómica, tiempo de internación, número de accesos, razón normal de retiro, el sexo, los antibióticos, mantenimiento intermitente y inserción de emergencia. CONCLUSIONES Se identificó la necesidad de estandarizar la cuantificación del evento y una línea baja entre los factores de riesgo asociados con la flebitis. Otros estudios necesitan ser desenvueltos para el real entendimiento de este agravio en la rutina hospitalario.

Abstract OBJECTIVE To describe the scientific evidence published in literature regarding the risk factors for the development of phlebitis. METHOD Integrative literature review with the inclusion of 14 original articles found in the LILACS, Scielo and Pubmed bases from January 2004 to April 2015, analyzed by levels of evidence and frequency, associated factors, degree and treatment of phlebitis. RESULTS The frequency / incidence / minimum rate of phlebitis was 3% and the maximum was 59.1%. Most articles (57.14%) reported an association of phlebitis with risk factors, including the dwell time, puncture site and / or anatomical region, hospitalization period, number of accesses, reason for removal, sex, antibiotics, intermittent maintenance and emergency insertion. CONCLUSIONS The need for standardizing the quantification of this event and a weak connection between the risk factors associated with phlebitis were identified. Further studies need to be developed in order to grant a real understanding of this disease in the daily routines of a hospital.

Ambiente de trabalho da enfermagem, segurança do paciente e qualidade do cuidado em hospital pediátrico / Entorno de trabajo de enfermería, la seguridad y la calidad de la atención en el hospital de pacientes pediátricos / Nursing work environment, patient safety and quality of care in pediatric hospital

RESUMO Objetivos Descrever as características do ambiente de trabalho, as atitudes de segurança, a qualidade do cuidado mensuradas pela equipe de enfermagem das unidades pediátricas e analisar a evolução dos indicadores assistenciais e de desempenho hospitalar. Método Estudo descritivo com 136 profissionais de enfermagem de um hospital pediátrico, com aplicação da ficha de caracterização pessoal e profissional, Nursing Work Index – Revised, Safety Attitudes Questionnaire – Short form 2006 e dos indicadores de qualidade. Resultados Os profissionais percebem o ambiente como favorável à prática profissional, avaliaram como boa a qualidade do cuidado e a redução de eventos adversos e da permanência hospitalar. O domínio satisfação no trabalho foi favorável à segurança do paciente. Conclusões O ambiente de trabalho é favorável à prática de enfermagem, os profissionais aprovam a qualidade do cuidado e os indicadores apontam redução dos eventos adversos e da permanência hospitalar.

RESUMEN Objetivos Describir las características del ambiente de trabajo, las actitudes hacia la seguridad, el cuidado de la calidad medida por el personal de enfermería de las unidades de pediatría, así como analizar la evolución de los indicadores de bienestar y desempeño de los hospitales. Métodos Estudio descriptivo con 136 profesionales en un asilo de ancianos hospital pediátrico, realizado a través de la forma de caracterización personal y profesional, Enfermería Índice de Trabajo – Revisado, Actitudes Seguridad Cuestionario – Short Form 2006 y los indicadores de calidad. Resultados Los profesionales perciben el ambiente tan favorable a la práctica profesional y de la buena calidad de la atención, una reducción de los eventos adversos y la estancia hospitalaria. Satisfacción en el trabajo se consideró favorable para la seguridad del paciente. Conclusiones El ambiente de trabajo es propicio para la práctica de los profesionales de enfermería que aprueban la calidad de la atención y la reducción de puntos de indicadores de los eventos adversos y la estancia hospitalaria.

ABSTRACT Objectives To describe the characteristics of the nursing work environment, safety attitudes, quality of care, measured by the nursing staff of the pediatric units, as well as to analyze the evolution of quality of care and hospital indicators. Methods Descriptive study with 136 nursing professionals at a paediatric hospital, conducted through personal and professional characterization form, Nursing Work Index – Revised, Safety Attitudes Questionnaire – Short Form 2006 and quality indicators. Results The professionals perceive the environment as favourable to professional practice, and consider good quality care that is also observed by reducing the incidence of adverse events and decreased length of stay. The domain job satisfaction was considered favourable to patient safety. Conclusions The work environment is favourable to nursing practice, the professionals nursing approve the quality of care and the indicators tended reducing adverse events and length of stay.

Incidence of phlebitis associated with the use of peripheral IV catheter and following catheter removal / Incidência de flebites durante o uso e após a retirada de cateter intravenoso periférico / Incidencia de flebitis durante el uso y después de la retirada de catéter intravenoso periférico

ABSTRACT Objective: to investigate the incidence of phlebitis and its association with risk factors when using peripheral IV catheters (PIC) and following their removal - (post-infusion phlebitis) in hospitalized adults. Method: a cohort study of 171 patients using PIC, totaling 361 punctures. Sociodemographic variables and variables associated with the catheter were collected. Descriptive and analytical statistical analyses were performed. Results: average patient age was 56.96 and 51.5% of the sample population was male. The incidence of phlebitis was 1.25% while using PIC, and 1.38% post-infusion. The incidence of phlebitis while using PIC was associated with the length of time the catheter remained in place, whereas post-infusion phlebitis was associated with puncture in the forearm. Ceftriaxone, Clarithromycin and Oxacillin are associated with post-infusion phlebitis. Conclusions: this study made it possible to investigate the association between risk factors and phlebitis during catheter use and following its removal. The frequency of post-infusion phlebitis was larger than the incidence of phlebitis with the catheter in place, with Phlebitis Grade III and II being the most frequently found in each of these situations, respectively. Aspects related to post-infusion phlebitis can be explained, given the limited number of studies addressing this theme from this perspective.

RESUMO Objetivo: investigar a incidência de flebites e a associação de fatores de risco com a sua ocorrência durante o uso e após a retirada do cateter intravenoso periférico - CIP (Flebite pós-infusão) em adultos hospitalizados. Método: estudo de coorte com 171 pacientes com CIP, totalizando 361 punções. Foram coletadas variáveis sociodemográficas e relacionadas ao cateter. Análise estatística descritiva e analítica. Resultados: dos pacientes, 51,5% eram homens e a média de idade foi de 56,96 anos. A incidência de flebites durante o uso do CIP foi de 1,25% e a pós-infusão foi de 1,38%. Associou-se à flebite durante o uso do CIP ao tempo de permanência do cateter e, com a flebite pós-infusão, a punção em antebraço. Os medicamentos Ceftriaxona, Claritromicina e Oxacilina foram associados à flebite pós-infusão. Conclusões: este estudo possibilitou investigar a associação de fatores de risco e a ocorrência de flebites durante o uso e após a retirada do cateter. A frequência da flebite pós-infusão foi maior do que o número de flebites durante a permanência do cateter, sendo as de grau III e II, respectivamente, as mais frequentes. Podem ser elucidados aspectos relacionados à flebite pós-infusão, considerando-se poucos estudos abordam o tema sob esta perspectiva.

RESUMEN Objetivo: investigar la incidencia de flebitis y la asociación de factores de riesgo con su ocurrencia durante el uso y después de la retirada del catéter intravenoso periférico (CIP) (flebitis post-infusión) en adultos hospitalizados. Método: estudio de cohorte con 171 pacientes con CIP, totalizando 361 punciones. Fueron recolectadas variables sociodemográficas y relacionadas al catéter. Análisis estadístico descriptivo y analítico. Resultados: de los pacientes, 51,5% eran hombres y el promedio de edad fue de 56,96 años. La incidencia de flebitis durante el uso del CIP fue de 1,25% y de post-infusión fue de 1,38%. Se asoció la flebitis durante el uso del CIP al tiempo de permanencia del catéter y con la post-infusión (punción en el antebrazo). Los medicamentos Ceftriaxona, Claritromicina y Oxacilina fueron asociados a la flebitis post-infusión. Conclusiones: este estudio posibilitó investigar la asociación de factores de riesgo y la ocurrencia de flebitis durante el uso y después de la retirada del catéter. La frecuencia de la flebitis post-infusión fue mayor que el número de flebitis asociada a la permanencia del catéter, siendo las de grado III y II, respectivamente, las más frecuentes. Se trato de elucidar aspectos relacionados a la flebitis post-infusión, considerando que existen pocos estudios que abordan el tema bajo esta perspectiva.

Risk factor for phlebitis: a questionnaire study of nurses' perception / Fatores de risco para flebite: estudo com questionário sobre a percepção dos enfermeiros / Factores de riesgo de la flebitis: un estudio con cuestionario de la percepción de las enfermeiras

AbstractObjectives: to assess nurses' perceptions of risk factors for the development of phlebitis, with a special focus on the perception of phlebitic potentials of some infusion medications and solutions.Method: a cross-sectional questionnaire study, which included a sample of 102 nurses.Results: Nurses recognized some factors that may reduce the incidence of phlebitis; however, more than half of the nurses were unaware that the material and diameter of the cannula can affect the incidence rate of phlebitis. Furthermore,underlying disease and high pH of medications or solutions were identified as potential risk factors, whereas low pH and low osmolality were not. Nurses identified Vancomycin and Benzylpenicillin antibiotics with the strongest phlebitic potential. Among other medications and intravenous fluids, Aminophylline, Amiodaronehydrochloride and Potassium chloride 7.4% were identified as potentially causing phlebitis.Conclusion: predisposing factors for phlebitis relating to patients and administered therapy were identified by nurses, while some cannula related risk factors, in particular its physicochemical properties and the time for cannula replacement, were not fully perceived.

ResumoObjetivos:avaliar a percepção de enfermeiros sobre os fatores de risco para desenvolvimento de flebite, com enfoque especial na percepção sobre os potenciais causadores de flebite de alguns medicamentos e soluções.Método:estudo transversal com questionário, que incluiu uma amostra de 102 enfermeiros.Resultados:os enfermeiros reconheceram alguns fatores que podem reduzir a incidência de flebite; no entanto, mais da metade dos enfermeiros ignorava que o material e o diâmetro do cateter poderiam afectar a taxa de incidência de flebite. Além disso, a doença de base e alto pH dos medicamentos ou soluções foram identificados como potenciais fatores de risco, porém o pH baixo e baixa osmolaridade não foram identificados. Os enfermeiros identificaram a Vancomicina e Benzilpenicilina como os antibióticos com o mais forte potencial flebitico. Entre outros medicamentos e fluidos intravenosos, foram identificados aminofilina, cloridrato de amiodarona e cloreto de potássio 7,4% como potencialmente causadores de flebite.Conclusão:os enfermeiros identificaram fatores predisponentes para flebite relacionados aos pacientes e à terapia administrada, enquanto alguns fatores de risco relacionados ao cateter, particularmente, suas propriedades físico-químicas e tempo para a substituição, não foram totalmente percebidos.

ResumenObjetivo:evaluar cómo perciben las enfermeras los factores de riesgo en el desarrollo de la flebitis, con atención especial a la percepción del potencial flebítico de algunos medicamentos y soluciones intravenosas.Método:un cuestionario transversal en el que se incluyó una población muestra de 102 enfermeras.Resultados:las enfermeras reconocieron algunos de los factores que pueden reducir la incidencia de la flebitis; sin embargo, más de la mitad de las enfermeras obviaron el hecho de que el material y el diámetro de la cánula pueden influir en la tasa de incidencia. De igual manera, las enfermedades subyacentes y el pH alto de los medicamentos y soluciones se identificaron como factores de riesgo potenciales, al contrario de un pH bajo y una baja osmolalidad. Las enfermeras identificaron que los antibióticos como la vancomicina y la bencilpenicilina tenían el mayor potencial flebítico. La aminofilina, el clorhidrato de amiodarona y el cloruro de potasio 7.4%, entre otros medicamentos y líquidos intravenosos, se identificaron como posibles causantes de la flebitis.Conclusión:Las enfermeras identificaron los factores de predisposición para la flebitis con relación a los pacientes y con las terapias administradas; mientras que algunos factores de riesgo relacionados con las cánulas no fueron apreciados en su totalidad, en particular aquellos relacionados a las propiedades fisicoquímicas y a los tiempos de remplazo de las cánulas.