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Name: Multi-Centre Research Surveillance Project to Reduce Infections/Phlebitis Associated with Peripheral
Description:
Phlebitis, inflammation of the vein associated with intra-vascular catheters, is caused by infection and reaction to physical-chemical irritants. Surveillance, the collection and feedback of data related to infection, is an accepted method of reducing the incidence of infection. Although phlebitis is not solely caused by infection it was decided to use this approach with the objective to reduce its incidence. The study was undertaken on surgical wards to reduce as far as possible the influence of other variables, i.e. similar categories.

A multi-centre surveillance project was devised to test the null hypothesis that: There is no difference in the proportion of phlebitis rates associated with peripheral vascular catheters (PVCs) following initial surveillance feedback. Infection control nurses (ICNs) from thirty-seven centres followed a surveillance programme devised at Glasgow Royal Infirmary. The study was designed to have 80% power to detect a 5% difference in phlebitis rates. The ICNs collected data on 40 PVCs in situ longer than 24 hours, input the data, analysed the results and fed them back and then repeated the study.

Data on 2,934 PVCs was collected by the ICNs. A significant difference was detected in the phlebitis rates after feedback. Four independent risk factors were identified: how long the device was insitu, what the device was used for, whether a pump was used and the surveillance period. All these risk factors were still significant after adjustment for other factors using logistic regression analysis.

Control groups were not used. Control groups prevent effects not caused by the intervention being wrongly attributed a so called Hawthorne effect. In surveillance programmes however a Hawthorne effect is part of the desired result. The null hypothesis was therefore rejected. There was a significant difference in the phlebitis rates between the surveillance periods. Although patients were not matched for clinical disease, the patients were of the same age and sex and the catheters were in situ for similar time periods. It is difficult to attribute the reduction to anything other than the surveillance programme itself. Further since 50% of centres results achieved a phlebitis rate of 5% or less, this figure can be seen as a benchmark for other surgical wards wishing to assess and reproduce the phlebitis rates on their wards.

Contents
1. Participants
2. Summary
3. Introduction
4. Causes and consequences of phlebitis
5. Rates of phlebitis and other complications
6. Sources of the organisms
7. Risk factors for the development of phlebitis
8. Surveillance
9. Objectives and methodology
10.Results
11.Discussion
12.Conclusions
13.Recommendations
14.References
15.Appendices
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