Controlling peripheral intravenous catheter failure by needleless connector design: A pilot randomised controlled trial

Article


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
Article Title

Controlling peripheral intravenous catheter failure by needleless connector design: A pilot randomised controlled trial

ERA Journal ID14104
Article CategoryArticle
AuthorsMarsh, 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.
Journal TitleJournal of Clinical Nursing
Journal Citation32 (21-22), pp. 7909-7919
Number of Pages11
Year2023
PublisherJohn Wiley & Sons
Place of PublicationUnited Kingdom
ISSN0962-1067
1365-2702
Digital Object Identifier (DOI)https://doi.org/10.1111/jocn.16852
Web Address (URL)https://onlinelibrary.wiley.com/doi/10.1111/jocn.16852
Abstract

Aim: To test the feasibility of a study protocol that compared the efficacy of neutral- and negative-pressure needleless connectors (NCs).

Design: A single-centre, parallel-group, pilot randomised control trial.

Methods: Our study compared neutral-(intervention) and negative-pressure (control) NCs among adult patients in an Australian hospital. The primary feasibility outcome was measured against predetermined criteria (e.g. eligibility, attrition). The primary efficacy outcome was all-cause peripheral intravenous catheter failure, analysed as time-to-event data.

Results: In total, 201 (100 control; 101 intervention) participants were enrolled between March 2020 and September 2020. All feasibility criteria were met except eligibility, which was lower (78%) than the 90% criterion. All-cause peripheral intravenous catheter failure was significantly higher in the intervention group (39%) compared to control (19%).

Conclusion: With minor modifications to participant screening for eligibility, this randomised control trial is feasible for a large multicentre randomised control trial. The neutral NC was associated with an increased risk of peripheral intravenous catheter failure.

Implications for the profession and/or patient care: There are several NC designs available, often identified by their mechanism of pressure (positive, negative and neutral). However, NCs can contribute to peripheral intravenous catheter failure. This is the first randomised controlled trial to compare neutral and negative NC designs. Negative pressure NCs had lower PIVC failure compared to neutral NCs, however the results might not be generalisable to other brands or treatment settings. Further high-quality research is needed to explore NC design.

Keywordsadult nursing; clinical; clinical trial; evidence-based nursing; health services research; nursing practice; nursing research; randomised controlled trials
ANZSRC Field of Research 2020420599. Nursing not elsewhere classified
Byline AffiliationsRoyal Brisbane and Women’s Hospital, Australia
Griffith University
University of Queensland
Queensland University of Technology
School of Nursing and Midwifery
Mater Research Institute, Australia
Metro North Health, Australia
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