Abstract • A prospective controlled trial was conducted on four similar inpatient medical wards to test the hypothesis that a trained Intravenous therapy (IVT) team would substantially reduce the incidence of peripheral intravenous (IV) catheter-related complications. We followed 863 IV catheters. The overall incidence of phlebitis in the ward staff—maintained IV catheters was 32% as compared with 15% for those maintained by the IVT team. The incidence of two more serious complications (cellulitis and suppurative phlebitis) was reduced tenfold from 2.1% to 0.2%. We conclude that an IVT team can substantially reduce the iatrogenic complications related to IV catheters. (Arch Intern Med 1984;144:1191-1194) References 1. Maki DG, Goldmann DA, Rhame FS: Infection control in intravenous therapy. Ann Intern Med 1973;79:867-887.Crossref 2. Maki DG: Infections associated with intravascular lines , in Remington JS, Swartz MN (eds): Current Clinical Topics in Infectious Diseases . New York, McGraw-Hill Book Co, 1982, pp 309-363. 3. Corso JA, Agostinelli R, Brandriss MW: Maintenance of venous polyethylene catheters to reduce risk of infection. JAMA 1969;210:2075-2077.Crossref 4. Simmons BP, Hooton TM, Wong ES, et al: Guidelines for prevention of intravascular infections. Infect Control 1982;3:61-67. 5. Fuchs PC: Indwelling intravenous polyethylene catheters: Factors influencing the risk of microbial colonization and sepsis. JAMA 1971;216: 1447-1450.Crossref 6. Bentley DW, Lepper MH: Septicemia related to indwelling venous catheter. JAMA 1968;206:1749-1752.Crossref 7. Bair JN, Petersen RV: The status of the IV therapy team in the genesis of intravenous therapy complications. Am JIV Ther 1979;6:39-58 8. Waggoner DM, Frengley JD, Griggs RC, et al: A 'firm' system for graduate training in general internal medicine. J Med Educ 1979;54:556-561. 9. Cohen DI, Littenberg B, Wetzel C, et al: Improving physicians' compliance with preventive medicine guidelines. Med Care 1982;20:1040-1045.Crossref 10. Collin J, Collin C, Constable FL, et al: Infusion thrombophlebitis and infection with various cannulas. Lancet 1975;12:150-153.Crossref 11. Fekety FR, Thoburn R: Drug letter: Nature and prevention of intravenous catheter infection. Johns Hopkins Med J 1967;121:134-135. 12. Tully JL, Friedland GH, Baldini LM, et al: Complications of intravenous therapy with steel needles and teflon catheters: A comparative study. Am J Med 1981;70:702-706.Crossref 13. Maki DG, Weise CE, Sarafin HW: A semiquantitative culture method for identifying intravenous-catheter-related infection. N Engl J Med 1977; 296:1305-1310.Crossref 14. Band JD, Maki DG: Safety of changing intravenous delivery systems at longer than 24-hour intervals. Ann Intern Med 1979;91:173-178.Crossref 15. Collins RN, Braun PA, Zinner SH, et al: Risk of local and systemic infection with polyethylene intravenous catheters: A prospective study of 213 catheterizations. N Engl J Med 1968;279:340-343.Crossref 16. Goldmann DA, Maki DG, Rhame FS, et al: Guidelines for infection control in intravenous therapy. Ann Intern Med 1973;79:848-850.Crossref 17. Maki DG, Band JD: A comparative study of polyantibiotic and iodophor ointments in prevention of vascular catheter-related infection. Am J Med 1981;70:739-744.Crossref 18. Stamm WE: Infections related to medical devices. Ann Intern Med 1978;89(pt 2):764-769.Crossref 19. Maki DG: Nosocomial bacteremia. Am J Med 1981;70:719-732.Crossref 20. Baker JA, Gardner C, Seymour SB: An approach to IV team development: Quality-cost determinations. Natl Intravenous Ther Assoc 1978;1:25-31.
Archives of Internal Medicine – American Medical Association
Published: Jun 1, 1984