Current Evidence for Prevention of the Complications Related to Peripheral Intravenous Catheterization: Systematic Review

Aim: Existing literature reports that incorrect and repeated interventions during peripheral intravenous catheterization (PIVC) can cause complications such as pain, phlebitis, and hematoma. This study was conducted to systematically examine the current evidence for the prevention of such complications encountered during PIVC procedures.

Method: In this study, we evaluated the most recent data found in relevant research papers retrieved from the databases Medline, Scopus, Cochrane, and CINAHL. This study includes manuscripts that (1) focused on the prevention of complications during PIVC procedures based on randomized clinical trials; (2) were published in the English language within the last 10 years; and (2) had accessible full text. Thirteen papers conforming to these inclusion criteria were evaluated. The keywords used for scanning the databases were “peripheral venous catheters,” “pain,” “phlebitis,” “ecchymosis,” “hematoma,” “peripheral venous catheters guideline,” and “nursing care.”

Results: An evaluation of these studies shows that the administration of local anesthetic sprays, creams, saline solutions, and lidocaine is effective in pain relief (n=5). Further investigation focused on prolonging the placement of the PIVC and decreasing the symptoms and findings related to pain, phlebitis, and hematoma; the investigation also revealed that these were experimental randomized controlled studies, which evaluated the catheter material (n=1), catheter type and insertion site (n=2), type of dressing used for the fixation (n = 2), and the length of stay of the PIVC (n=3). These studies emphasized that large veins are preferred because they do not restrict the mobility of the patient when using vialon catheters. They recommend that catheters always be selected on the basis of their suitability for the patient and the treatment (Size: 18G–22G). Catheters with transparent dressings should be examined for the signs and symptoms of phlebitis. Furthermore, it was stated that catheters might stay in place for 96 hours if no complications are encountered during the examinations performed every eight hours after the PIVC procedure. Routine catheter replacement is not recommended due to repetitive exposure to pain, increased cost, and larger workload for the caregiver staff.

Conclusion: To sum up, our study presents evidence to determine the current best approach toward the prevention of complications during PIVC procedures, and that our findings will guide nurses in the implementation of positive results