背景

The aim of this systematic review and meta  ‐  analysis was tosummarize and quantify peripheral intravenous catheter  ‐  relatedcomplications.

 

Design  

This systematic review is reported by meansof the Cochrane process for randomized controlled trials and the Meta‐analysis ofObservation Studies in Epidemiology for cohort studies.

 

Datasources  

The Cochrane Central Register of ControlledTrials, PubMed, CINAHL and EMBASE databases, clinical trial registries such asClinicalTrials.gov and the reference list of included studies were searchedfrom 2000 ‐April 2019.

 

Review Methods  

Using a purpose designed data extractiontool, two authors independently identified studies for full review, dataextraction and quality assessment. Dichotomous outcomes were pooled afterFreeman–Tukey double arcsine transformation using random‐effects meta‐analysis;estimates of heterogeneity were taken from inverse‐variance fixed‐effect models.

 

Results  

Seventy observational studies and 33randomized controlled trials were included (76,977 catheters). Peripheralintravenous catheter‐related complications wereas follows: phlebitis (with definition) 19.3%, phlebitis (without definition)4.5%, infiltration/extravasation 13.7%, occlusion 8%, leakage 7.3%, pain 6.4%and dislodgement 6.0%. Subgroup analysis found infiltration/extravasation foremergency department‐inserted catheters wassignificantly higher (25.2%; p = .022)than for those inserted in other departments and pain was significantly higher (p < .001) in countries withdeveloping economies compared with developed economies.

 

Conclusion  

Peripheral intravenous catheter complicationsare unacceptably common worldwide. This review suggests substantial and multi‐specialtyefforts are needed to address the sequalae associated with complications. Thepotential benefits for patients and health services are considerable ifcomplications are reduced.

 

Impact  

Peripheral intravenous complicationsinterrupt important treatment which can be distressing for patients and resultin longer hospital stays with increased healthcare costs. This review foundphlebitis and infiltration are the most prevalent reason for catheter failure.These results provide nurses with a strong evidence base for the development ofeffective interventions for practice which are vital for preventing pooroutcomes for patients with peripheral intravenous catheters.