Article Summary
“A randomized controlled study to evaluate the effectiveness of 2 treatment methods in reducing incidence of short peripheral catheter-related phlebitis”
Physicians and nurses use short peripheral catheters (SPC) to administer fluids, drugs, and blood products to patients. Approximately 70 % of patients in acute care hospitals require SCP. Although the SPC procedure becomes necessary in caring for patients, is the insertion of the catheter is not risk-free. The process of inserting the SPC into the vein increases the risks for phlebitis, causing pain, interrupting the infusion therapy, and consequently necessitating the insertion of another catheter. Phlebitis can also be a source of bloodstream infections due to the possible compromise of subsequent vascular access. The inflammation of the vein can be classified into mechanical, chemical, and bacterial phlebitis. Nurses and physicians conduct pre-insertion skin antisepsis using 2% aqueous chlorhexidine to minimize possible SPC infections. A treatment after SPC removal can also reduce the incidences of post-infusion phlebitis. Therefore, Gunasegaran et al. (2018) investigated the effectiveness of cleaning solutions and dressing materials before and after SPC insertion in reducing the rate of SPC-related phlebitis.
The article evaluates the effectiveness of two treatment methods in reducing the rate of phlebitis associated with SPC. The first one involves the use of 70% isopropyl alcohol swabs and application of adhesive bandage and the other 2% chlorhexidine in 70% isopropyl alcohol swab and application of film dressing before and after SPC insertion. The study was a randomized controlled trial that involved 960 participants, 538 in treatment method 1 and 422 in method 2. The authors collected data between April 2014 and July 2015. All participants were supposed to have an SPC in their upper limbs and be of 21 to 99 years. Signs of phlebitis signs during SPC infusion therapy or with 48 hours SPC removal were recorded. The authors presented the observed incidents of phlebitis using percentages and frequencies and evaluated differences between the two treatment methods using Fisher exact test. The findings indicate that more participants in treatment method 1(70% isopropyl alcohol swabs and adhesive bandage) experienced phlebitis. However, the difference between the two methods was insignificant.
View of the Article’s Balance
The article’s main focus was to assess which treatment method would effectively reduce the rate of SPC-related phlebitis. Although the number of participants in each treatment method is not equal, the article can be considered balanced due to the procedure involved in recruiting the study’s subjects. All the participants were randomly selected and had the common site of SPC insertion. Additionally, the baseline features among the patients who participated in the two treatment methods were similar in terms of infection at admission, drugs administered, and the period the catheter was in situ. Although treatment method 1(of 70% isopropyl alcohol swabs and application of adhesive bandage) has been the standard care in most healthcare facilities, the authors tried as much as possible to balance participants in the two therapy approaches. This factor can also explain why more participants were in treatment method one than in method 2, which had no significant impact on testing their effectiveness.
Opinion about the Article’s Quality
The research article is of good quality and can help change the perspectives of nursing practitioners who may be thinking one of the treatment methods evaluated is more effective than the other. The authors of this article did sufficient research that helped them make their conclusions. They acknowledge the risks of phlebitis due to the high number of patients (70%) in acute care settings who use SPC, which serves as the foundation of the study. They also researched methods used to minimize the rate of SPC-related phlebitis and decided to evaluate their effectiveness. The procedure used to recruit participants, the sample size, and the way data was collected was to make a conclusion about the study.
The article is technically correct and clearly presented and supported. Undeniably, different treatment methods are expected to have dissimilar outcomes. Therefore, it is imperative to test their effectiveness to ensure that only the superior is used frequently to guarantee better patient outcomes. The authors clearly presented all the information, including collected and analyzed, making it easier to follow and understand the article. For instance, they used tabled to present the frequency and percentages of phlebitis incidences among the participants. They also used previous studies to support their discussion regarding the study’s findings. For example, they indicated that other studies have shown that the solutions used in the two treatment methods significantly reduce the risks for SPC contamination. The information borrowed from other studies supports the findings that the types of cleaning solutions and dressing material used after removal of SPC have an insignificant impact on the phlebitis incidence rate.
The authors conclude that adherence to universal policies for infection prevention and compliance with hand hygiene practices are instrumental approaches to preventing phlebitis. However, this argument could have provided more details using data from previous research. A follow-up research article should test the effectiveness of post-removal alone in preventing SPC-related phlebitis using a larger sample size. I agree with the article that safe clinical practices when inserting and removing SPC are superior in preventing phlebitis than any of the tested products.
Reference
Gunasegaran, N., See, M. T., Leong, S. T., Yuan, L. X., & Ang, S. Y. (2018). A randomized controlled study to evaluate the effectiveness of 2 treatment methods in reducing incidence of short peripheral catheter-related phlebitis. Journal of Infusion Nursing, 41(2), 131–137. Web.