Flushing of peripheral intravenous catheters: A pilot, factorial, randomised controlled trial of high versus low frequency and volume in paediatrics

Article


Kleidon, Tricia M., Keogh, Samantha, Flynn, Julie, Schults, Jessica, Mihala, Gabor and Rickard, Claire M.. 2020. "Flushing of peripheral intravenous catheters: A pilot, factorial, randomised controlled trial of high versus low frequency and volume in paediatrics." Journal of Paediatrics and Child Health. 56 (1), pp. 22-29. https://doi.org/10.1111/jpc.14482
Article Title

Flushing of peripheral intravenous catheters: A pilot, factorial, randomised controlled trial of high versus low frequency and volume in paediatrics

ERA Journal ID16465
Article CategoryArticle
AuthorsKleidon, Tricia M. (Author), Keogh, Samantha (Author), Flynn, Julie (Author), Schults, Jessica (Author), Mihala, Gabor (Author) and Rickard, Claire M. (Author)
Journal TitleJournal of Paediatrics and Child Health
Journal Citation56 (1), pp. 22-29
Number of Pages8
Year2020
PublisherJohn Wiley & Sons
Place of PublicationUnited Kingdom
ISSN1034-4810
1440-1754
Digital Object Identifier (DOI)https://doi.org/10.1111/jpc.14482
Web Address (URL)https://onlinelibrary.wiley.com/doi/10.1111/jpc.14482
Abstract

Aim: To test the feasibility of an efficacy trial comparing different flushing frequencies and volumes to reduce peripheral intravenous cannula (PIVC) failure in paediatric inpatients. Methods: Pilot, 2 × 2 factorial, randomised controlled trial comparing PIVC flushing techniques in intervention pairs: (i) low volume (3 mL) versus high volume (10 mL); and (ii) low frequency (24 hourly) versus high frequency (6 hourly). Patients were excluded if: fluids were restricted, weight < 5 kg, PIVC already in situ for >24 h or continuous infusion. The primary end-point was feasibility (eligibility, recruitment, retention, protocol adherence, missing data and sample size estimates) of a large trial. Secondary end-points were PIVC failure (composite and individual), bloodstream infection and mortality. Results: A total of 919 children were screened from April to November 2015, with 55 enrolled. Screening feasibility criteria were not met, mainly due to continuous infusions and PIVCs in situ >24 h or planned for imminent removal. However, 80% of eligible participants consented, 2% withdrew, protocol adherence was 100%, and there was no missing primary end-point data. PIVC failure was significantly higher (hazard ratio = 2.90, 95% confidence interval: 1.11–7.54) in the 3 mL compared to the 10 mL group. There was no difference in failure between frequency groups (hazard ratio = 0.91, 95% confidence interval: 0.36–2.33). There was no interaction effect (P = 0.22). Conclusion: Trial feasibility proved challenging due to eligibility criteria, which could be improved with additional recruiting staff. Firm conclusions cannot be made based on this small sample, but flush volume may impact PIVC failure.

Keywordsadverse effects; catheterisation; paediatric; peripheral venous device; randomised controlled trial
ANZSRC Field of Research 2020420506. Sub-acute care
420501. Acute care
420599. Nursing not elsewhere classified
Byline AffiliationsDepartment of Health, Queensland
Griffith University
Institution of OriginUniversity of Southern Queensland
Permalink -

https://research.usq.edu.au/item/q6w50/flushing-of-peripheral-intravenous-catheters-a-pilot-factorial-randomised-controlled-trial-of-high-versus-low-frequency-and-volume-in-paediatrics

  • 78
    total views
  • 3
    total downloads
  • 2
    views this month
  • 0
    downloads this month

Export as

Related outputs

Controlling peripheral intravenous catheter failure by needleless connector design: A pilot randomised controlled trial
Marsh, Nicole, Larsen, Emily, O'Brien, Catherine, Peach, Hannah, Keogh, Samantha, Davies, Karen, Mihala, Gabor, Hewer, Barbara, Booker, Catriona, McCarthy, Alexandra L., Flynn, Julie and Rickard, Claire M.. 2023. "Controlling peripheral intravenous catheter failure by needleless connector design: A pilot randomised controlled trial." Journal of Clinical Nursing. 32 (21-22), pp. 7909-7919. https://doi.org/10.1111/jocn.16852
Safety and efficacy of midline catheters versus peripheral intravenous catheters: A pilot randomized controlled trial
Marsh, Nicole, Larsen, Emily N., O'Brien, Catherine, Ware, Robert S., Kleidon, Tricia M., Groom, Peter, Hewer, Barbara, Alexandrou, Evan, Flynn, Julie, Woollett, Kaylene and Rickard, Claire M.. 2022. "Safety and efficacy of midline catheters versus peripheral intravenous catheters: A pilot randomized controlled trial." International Journal of Nursing Practice. 29 (2), pp. 1-11. https://doi.org/10.1111/ijn.13110
Comparing compliance with commencement and use of two partograph designs for women in active labour: A randomised controlled trial
Lee, Nigel, Flynn, Julie, Gao, Yu and Kildea, Sue. 2023. "Comparing compliance with commencement and use of two partograph designs for women in active labour: A randomised controlled trial." Women and Birth. 36 (1), pp. e17-e24. https://doi.org/10.1016/j.wombi.2022.04.004
Reimagining the role of nursing education in emissions reduction
Ward, Aletha, Heart, Diane, Richards, Catelyn, Bayliss, Luke T., Holmes, Mark, Keogh, Samantha and Best, Odette. 2022. "Reimagining the role of nursing education in emissions reduction." Teaching and Learning in Nursing. 17 (4), pp. 410-416. https://doi.org/10.1016/j.teln.2022.02.003
Evaluating methods for the use and decontamination of needleless connectors: A qualitative inquiry
Larsen, Emily N., August, Deanne, Keogh, Samantha, Flynn, Julie, Ullman, Amanda J., Marsh, Nicole, Cooke, Marie, McCarthy, Alexandra L. and Rickard, Claire M.. 2022. "Evaluating methods for the use and decontamination of needleless connectors: A qualitative inquiry." Infection, Disease and Health. 27 (4), pp. 175-183. https://doi.org/10.1016/j.idh.2022.04.002
Response to the Letter to the Editor regarding “Methods for microbial needleless connector decontamination: A systematic review and meta-analysis”
Flynn, Julie M., Larsen, Emily N., Keogh, Samantha, Ullman, Amanda J. and Rickard, Claire M.. 2019. "Response to the Letter to the Editor regarding “Methods for microbial needleless connector decontamination: A systematic review and meta-analysis”." American Journal of Infection Control. 47 (12), pp. 1521-1522. https://doi.org/10.1016/j.ajic.2019.07.002
Securement methods for peripheral venous catheters to prevent failure: a randomised controlled pilot trial
Marsh, Nicole, Webster, Joan, Flynn, Julie, Mihala, Gabor, Hewer, Barbara, Fraser, John and Rickard, Claire. 2015. "Securement methods for peripheral venous catheters to prevent failure: a randomised controlled pilot trial." The Journal of Vascular Access. 16 (3), pp. 237-244. https://doi.org/10.5301/jva.5000348
Needleless connector decontamination: To use, or not to use, chlorhexidine?
Flynn, Julie, Slater, Karen, Cooke, Marie and Rickard, Claire M.. 2018. "Needleless connector decontamination: To use, or not to use, chlorhexidine?" American Journal of Infection Control. 46 (8), pp. 959-960. https://doi.org/10.1016/j.ajic.2018.03.003
An observational study of nurses’ intravenous flush and medication practice in the clinical setting
Keogh, Samantha, Shelverton, Caroline, Flynn, Julie, Davies, Karen, Marsh, Nicole and Rickard, Claire M.. 2017. "An observational study of nurses’ intravenous flush and medication practice in the clinical setting." Vascular Access. 3 (1), pp. 1-18. https://doi.org/10.3316/informit.629496319613481
Evaluating methods for effective decontamination of central venous access devices needleless connectors in adult hospital patients: A pilot randomised control trial protocol
Flynn, Julie M., Keogh, Samantha, Zhang, Li and Rickard, Claire M.. 2017. "Evaluating methods for effective decontamination of central venous access devices needleless connectors in adult hospital patients: A pilot randomised control trial protocol." Vascular Access. 3 (2), pp. 1-18. https://doi.org/10.3316/informit.632663924727375
The MIDLINE trial – managing intravenous devices among patients with limited vascular access or prolonged therapy: a pilot randomised control trial protocol
Marsh, Nicole, Larsen, Emily, Flynn, Julie, O’Brien, Catherine, Kleidon, Tricia, Groom, Peter, Hewer, Barbara and Rickard, Claire M.. 2020. "The MIDLINE trial – managing intravenous devices among patients with limited vascular access or prolonged therapy: a pilot randomised control trial protocol." Vascular Access. 6 (1), pp. 20-24. https://doi.org/10.33235/va.6.1.20-24
Maternal positioning with flexed thighs to correct foetal occipito-posterior position in labour: A systematic review and meta-analysis
Lee, Nigel, Munro, Victoria, Oliver, Kirra and Flynn, Julie. 2021. "Maternal positioning with flexed thighs to correct foetal occipito-posterior position in labour: A systematic review and meta-analysis." Midwifery. 99. https://doi.org/10.1016/j.midw.2021.103008
Disinfection of Needleless Connector Hubs: Clinical Evidence Systematic Review
Moureau, Nancy L. and Flynn, Julie. 2015. "Disinfection of Needleless Connector Hubs: Clinical Evidence Systematic Review." Nursing Research and Practice. 2015, pp. 1-20. https://doi.org/10.1155/2015/796762
Nursing and midwifery practice for maintenance of vascular access device patency. A cross-sectional survey
Keogh, Samantha, Flynn, Julie, Marsh, Nicole, Higgins, Niall, Davies, Karen and Rickard, Claire M.. 2015. "Nursing and midwifery practice for maintenance of vascular access device patency. A cross-sectional survey." International Journal of Nursing Studies. 52 (11), pp. 1678-1685. https://doi.org/10.1016/j.ijnurstu.2015.07.001
Alcohol Caps or Alcohol Swabs With and Without Chlorhexidine: An In Vitro Study of 648 Episodes of Intravenous Device Needleless Connector Decontamination
Flynn, Julie M., Rickard, Claire M., Keogh, Samantha and Zhang, Li. 2017. "Alcohol Caps or Alcohol Swabs With and Without Chlorhexidine: An In Vitro Study of 648 Episodes of Intravenous Device Needleless Connector Decontamination." Infection Control and Hospital Epidemiology. 38 (5), pp. 617-619. https://doi.org/10.1017/ice.2016.330
Infection risks associated with peripheral vascular catheters
Zhang, Li, Cao, Siyu, Marsh, Nicole, Ray-Barruel, Gillian, Flynn, Julie, Larsen, Emily and Rickard, Claire M.. 2016. "Infection risks associated with peripheral vascular catheters." Journal of Infection Prevention. 17 (5), pp. 207-213. https://doi.org/10.1177/1757177416655472
Methods for microbial needleless connector decontamination: A systematic review and meta-analysis
Flynn, Julie M., Larsen, Emily N., Keogh, Samantha, Ullman, Amanda J. and Rickard, Claire M.. 2019. "Methods for microbial needleless connector decontamination: A systematic review and meta-analysis." American Journal of Infection Control. 47 (8), pp. 956-962. https://doi.org/10.1016/j.ajic.2019.01.002
Varied flushing frequency and volume to prevent peripheral intravenous catheter failure: a pilot, factorial randomised controlled trial in adult medical-surgical hospital patients
Keogh, Samantha, Flynn, Julie, Marsh, Nicole, Mihala, Gabor, Davies, Karen and Rickard, Claire. 2016. "Varied flushing frequency and volume to prevent peripheral intravenous catheter failure: a pilot, factorial randomised controlled trial in adult medical-surgical hospital patients." Trials. 17 (1), pp. 1-10. https://doi.org/10.1186/s13063-016-1470-6
Central venous Access device SeCurement And Dressing Effectiveness for peripherally inserted central catheters in adult acute hospital patients (CASCADE): a pilot randomised controlled trial
Chan, Raymond J., Northfield, Sarah, Larsen, Emily, Mihala, Gabor, Ullman, Amanda, Hancock, Peter, Marsh, Nicole, Gavin, Nicole, Wyld, David, Allworth, Anthony, Russell, Emily, Choudhury, Md Abu, Flynn, Julie and Rickard, Claire M.. 2017. "Central venous Access device SeCurement And Dressing Effectiveness for peripherally inserted central catheters in adult acute hospital patients (CASCADE): a pilot randomised controlled trial." Trials. 18 (1), pp. 1-13. https://doi.org/10.1186/s13063-017-2207-x
Implementation and evaluation of short peripheral intravenous catheter flushing guidelines: a stepped wedge cluster randomised trial
Keogh, Samantha, Shelverton, Caroline, Flynn, Julie, Mihala, Gabor, Mathew, Saira, Davies, Karen M., Marsh, Nicole and Rickard, Claire M.. 2020. "Implementation and evaluation of short peripheral intravenous catheter flushing guidelines: a stepped wedge cluster randomised trial." BMC Medical. 18 (1), pp. 1-11. https://doi.org/10.1186/s12916-020-01728-1
Needleless connector decontamination for prevention of central venous access device infection: A pilot randomized controlled trial
Rickard, Claire M., Flynn, Julie, Larsen, Emily, Mihala, Gabor, Playford, E Geoffrey, Shaw, Joanie, Keogh, Samantha, Ullman, Amanda, Zhang, Li, Gavin, Nicole, Kleidon, Tricia, Chopra, Vineet, McCarthy, Alexandra L., Rocha, Patricia Kuerten and Marsh, Nicole. 2021. "Needleless connector decontamination for prevention of central venous access device infection: A pilot randomized controlled trial." American Journal of Infection Control. 49 (2), pp. 269-273. https://doi.org/10.1016/j.ajic.2020.07.026
Clinically-indicated replacement versus routine replacement of peripheral venous catheters [Review]
Webster, J., Osborne, S., Rickard, C. M. and Hall, J.. 2010. "Clinically-indicated replacement versus routine replacement of peripheral venous catheters [Review]." Cochrane Database of Systematic Reviews. 2010 (3), pp. 1-41.
Clinically-indicated replacement versus routine replacement of peripheral venous catheters [Review]
Webster, J., Osborne, S., Rickard, C. M. and New, K.. 2013. "Clinically-indicated replacement versus routine replacement of peripheral venous catheters [Review]." Cochrane Database of Systematic Reviews. 2013 (4), pp. 1-42.
Clinically-indicated replacement versus routine replacement of peripheral venous catheters [Review]
Webster, J., Osborne, S., Rickard, C. and New, K.. 2015. "Clinically-indicated replacement versus routine replacement of peripheral venous catheters [Review]." Cochrane Database of Systematic Reviews. 2015 (8), pp. 1-45. https://doi.org/10.1002/14651858.CD007798.pub4
Prevention of Occlusion of cEnTral lInes for Children with cancer: An implementation study
Ullman, Amanda J., Condon, Paula, Edwards, Rachel, Gibson, Victoria, Takashima, Mari, Schults, Jessica, Dean, Anna, Cattanach, Paula, Nicholls, Wayne, Osborne, Sonya, Rickard, Claire M., Cooke, Marie and Kleidon, Tricia. 2020. "Prevention of Occlusion of cEnTral lInes for Children with cancer: An implementation study." Journal of Paediatrics and Child Health. 56 (12), pp. 1875-1884. https://doi.org/10.1111/jpc.15067
Clinically-indicated replacement versus routine replacement of peripheral venous catheters
Webster, Joan, Osborne, Sonya, Rickard, Claire M and Marsh, Nicole. 2019. "Clinically-indicated replacement versus routine replacement of peripheral venous catheters." Cochrane Database of Systematic Reviews. 2019 (1), pp. i-55. https://doi.org/10.1002/14651858.CD007798.pub5
Sterile v aseptic non-touch technique for needle-less connector care on central venous access devices in a bone marrow transplant population: A comparative study
Flynn, Julie M., Keogh, Samantha J. and Gavin, Nicole C.. 2015. "Sterile v aseptic non-touch technique for needle-less connector care on central venous access devices in a bone marrow transplant population: A comparative study." European Journal of Oncology Nursing (EJON). 19 (6), pp. 694-700. https://doi.org/10.1016/j.ejon.2015.05.003
Clinically-indicated replacement versus routine replacement of peripheral venous catheters [Review]
Webster, Joan, Osborne, Sonya, Rickard, Clare M. and New, Karen. 2013. "Clinically-indicated replacement versus routine replacement of peripheral venous catheters [Review]." Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD007798.pub3