Low-angled peripheral intravenous catheter tip placement decreases phlebitis

Area of Science:

• Medical Devices
• Vascular Access
• Patient Safety

Background:

• Peripheral intravenous catheters (PIVCs) are prone to removal due to phlebitis.
• Catheter material flexibility may influence phlebitis incidence.
• Catheter-tip angle as a potential indicator of phlebitis risk.

Purpose of the Study:

• To compare phlebitis rates between polyurethane and Teflon PIVCs.
• To investigate the correlation between catheter-tip angle and phlebitis.
• To assess if catheter flexibility impacts phlebitis.

Main Methods:

• Observational study comparing Teflon (n=200) and polyurethane (n=207) PIVCs.
• Phlebitis assessed using the Infusion Nurses Society scale.
• Ultrasonography used to measure catheter-tip angle relative to the vessel wall.

Main Results:

• Polyurethane PIVCs showed significantly lower phlebitis rates (17%) than Teflon PIVCs (37%).
• Median catheter-tip angles were lower for polyurethane (4.1°) vs. Teflon (7.8°).
• Phlebitis risk increased with catheter-tip angles greater than 5.8°.

Conclusions:

• Polyurethane catheters are associated with reduced phlebitis.
• Lower catheter-tip angles, indicating near-parallel placement to the vessel, correlate with less phlebitis.
• Findings support developing more flexible catheters and improved securement techniques for PIVCs.