Indwelling time complications and itss associated factors of open peripheral intravenous cannulation in adult patients admitted to medical and surgical wards in Teaching Hospital Batticaloa.

Abstract

Peripheral intravenous catheters (PIVC) are medical devices most frequently used during hospital care. Although the frequency of specific PIVC related adverse effect has been reported during the insertion time, indwelling time, and after catheter removal. Worldwide several technologies are introduced and followed in intravenous cannulation procedures. But there are no more studies available on the current practice and laps in peripheral cannulation in Sri Lanka. Therefore our study aimed to determine the indwelling time, complications, and risk factors associated with PIVC complications. The objectives are to describe the current evidence on indwelling time, complications and its associated factors of open peripheral intravenous cannulation in adult patients admitted to Teaching Hospital Batticaloa. A Cross-sectional observational study was conducted from February 2022 to December 2022 among adult 388 patients who were admitted to the medical and surgical wards in Teaching Hospital Batticaloa. The study population was the adult patient who had peripheral intravenous cannulation during their hospitalization. The sampling method is convenience sampling. The statistical package of Social Science 26(SPSS v.26) was used for analyzing, and interpreting the data. The mean indwelling time was 61hrs and 25min (± 25.58hrs) (range4-141hrs). Chi square test analysis showed that the site of the study (medical/surgical wards) (p=0.01), BMI of the participants (p=0.001), smoking (p=0.009), alcohol consumption (p= 0.000), dextrose infusion (5%) (p=0.000) & anti-emetic injection (p=0.050) were the factors associated with the indwelling time. Most participants (n=339, 87.4%) had removed the cannula due to complications. Among that more than half of the participants had occlusion and obstruction (n=197, 58.1%), phlebitis (n=75, 22%), accidental removal or dislodgement (n=33, 9.7%), seepage and leakage (n=20, 5.9%) & infiltration (n=14, 4.1%). The significant factors associated with complications are the site of the insertion (p=0.026), gauge of the cannula (p= 0.000), used for blood transfusion (p=0.02), ringer lactates infusion (p= 0.05), administration of maintenance fluids (p= 0.014), Normal saline infusion (p= 0.004), indwelling time (p= 0.010), corticosteroid administration (p= 0.05) and the age of the participant (p=0.046). Open PIVC-related complications are highly occurred in the participants. Therefore it is beneficial to upgrade the cannulation practices & to replace the cannulas with closed PIVC. Keywords: Indwelling time, Open peripheral Intra-venous cannula, Complications, Adult patients, Risk factors, Phlebitis