Griffith University researchers have compared dressings and securements for preventing peripheral intravenous catheter (PIVC) failure in adults, and published their results in The Lancet. PIVCs are the most common invasive medical devices used in hospitals; around 2 billion devices are sold around the world each year, and most patients admitted to hospital require intravenous therapy. PIVC failure is unacceptably frequent: as many as 69% of devices require removal because of dislodgement, pain, occlusion, leakage, or infection. The National Health and Medical Research Council funded the investigation at the Royal Brisbane and Women’s Hospital and the Princess Alexandra Hospital in Brisbane. In the trial, 1807 eligible patients aged 18 years or more who required PIVC insertion for longer than 24 hours were randomly assigned to receiving tissue adhesive with polyurethane dressing, bordered polyurethane dressing, a securement device with polyurethane dressing, or polyurethane dressing (control group). Overall, PIVC failure affected 41% of patients. None of the interventions significantly reduced PIVC failure; all tested products, including the standard polyurethane, were subject to PIVC failure and often needed reinforcement. The researchers wrote that innovations for achieving effective, durable products are urgently needed, but also that substantial savings could be made by the Australian health system were clinicians to use low cost polyurethane dressings for PIVCs, given the lack of a clinical rationale for more expensive products.
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