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Problem
Peripheral venous catheters (PVCs), such as those routinely inserted in busy oncology units all over the UK, can cause infections ranging from local phlebitis to cellulitis to severe sepsis. Data regarding the frequency of phlebitis or cellulitis related to PVCs are not routinely collected. However, data concerning patients with Staphylococcus aureus bacteraemia is collected by infection control practitioners in our hospital, who investigate all cases and assess relationship to PVCs. An incident of 11% is estimated in the wider community of UK hospitals that are considered to be the same as in Castle Hill Hospital (phlebitis induced by cannulas is estimated between at 25-75% in different studies).
The introduction of the visual infusion phlebitis (VIP) score tool for assessment of early signs of phlebitis,and prompt removal of peripheral intravenous cannulas, has been very successful in reducing the incidence below the acceptable rate of 5%. However, achieving this goal depends on strict compliance with guidelinesfor cannula insertion, documentation and assessment using the VIP tool.
Background
Healthcare workers insert peripheral intravenous (PIV) catheters every day into the majority of patients who are admitted to an acute care facility. It is estimated that 150 million PIV catheters are inserted annually in the United States, with an increasing use of medication therapy that is toxic to the veins. Early studies found that 25%-70% of all the patients receiving PIV therapy developed infusion-related phlebitis, defined as the inflammation of a vein, with an acceptable rate of phlebitis at 5%.[5] Infusion-related phlebitis may develop while the intravenous catheter is...