Infusion thrombophlebitis in a surgical department

Area of Science:

• Medical Science
• Clinical Practice
• Surgical Nursing

Background:

• Thrombophlebitis is a common complication of intravenous (IV) infusions, with reported incidences of 27-43% when using 5% glucose solutions.
• High rates of thrombophlebitis necessitate the development and implementation of strategies to mitigate infusion-related complications.

Purpose of the Study:

• To evaluate the effectiveness of a set of established principles in reducing the incidence of infusion thrombophlebitis in a surgical department.
• To assess the impact of specific IV fluid administration protocols on patient outcomes related to vein inflammation.

Main Methods:

• A prospective study was conducted over 4 months, implementing five key principles for IV solution administration.
• Principles included: limiting cannula dwell time to 24 hours, neutralizing sugar solutions, using thinnest cannulas, rapid administration of irritant solutions, and prioritizing larger veins.
• Data collected from 196 patients receiving infusions for a total of 529 days, with a focus on 113 patients receiving 10% invertose.

Main Results:

• Overall incidence of infusion thrombophlebitis decreased significantly to 6.1% (3-10%) across all patients.
• Patients receiving 1000-2000 ml of 10% invertose daily experienced a higher thrombophlebitis rate of 9.7% (5-17%).
• No patient developed more than one episode of infusion thrombophlebitis during the study period.

Conclusions:

• The implemented principles for IV fluid administration were effective in substantially reducing the overall incidence of infusion thrombophlebitis.
• While overall rates improved, 10% invertose solutions were associated with a higher risk, suggesting careful consideration for their use.
• The findings support the adoption of standardized protocols to enhance patient safety and reduce complications associated with IV therapy.