Which complication of intravenous IV therapy is caused by a dislodged catheter?
October 2017 When clinicians place intravenous catheters,
they secure them to the catheter insertion site with one of several methods. If their chosen securement method fails, the catheter may become displaced. The name for this complication is “IV dislodgement.” Catheters are normally secured to the insertion site with standard medical tape or an adhesive-based engineered securement device also applied to the skin. Extent of DislodgementRoughly 70% to 90% of hospitalized patients in the U.S. receive IV therapy at some point during their hospital stay.1 While no published studies have yet focused specifically on accidental dislodgement, rates of occurrence are available in published research on related issues – e.g. IV catheter-related complications. Dislodgement rates in five published prospective randomized studies reviewed in 2015 by Helm et al. range from 3.7%-9.9%, with a mean of 6.9% and a median of 7.3%. The same authors calculated the mean dislodgement rate to be even higher in eight prospective observational studies they reviewed, at 17.5%, with the median dislodgement rate being 9.2%.1 Prospective data presented by Nicole Marsh, RN, Ph.D. and Claire Rickard, RN, Ph.D. at the Association for Vascular Access (AVA) Annual Scientific Meeting in 2017 reported a 10% dislodgement rate for 1,000 patients fitted with peripheral IV catheters.2 The number of peripheral IV catheters sold in the U.S. is approximately 330 million.3 A 10% mean dislodgement rate translates to 33 million dislodgements per year in the U.S. alone. Associated Clinical ComplicationsAt minimum, IV dislodgement will lead to an unscheduled IV restart, which is inconvenient and uncomfortable to the patient. More serious consequences could include the need to fit the patient with a more invasive central line if dislodgement causes loss of peripheral IV site integrity; increased risk of phlebitis, infiltration, and infection; and longer treatment delays. Among the worst case scenarios are bleedouts, air embolisms, and bloodstream infections that result in the patient’s death. Nurses are placed at an increased risk by dislodgements due to increase in potential of sharps exposures and injuries, plus blood or drug exposure. Clinicians Know IV Dislodgement Is a Serious ProblemSURVEY: An extensive survey recently probed the experiences and attitudes of nurses regarding IV dislodgements. The survey was aimed at two nurse sub-groups: bedside nurses and nurse specialists performing replacement of dislodged devices. Of the 18,895 nurses who received the survey, 1,567 responded. Here is a summary of results of the survey, which was presented as a scientific poster at the annual Association for Vascular Access conference:
FOCUS GROUP: The manufacturer of the Orchid Safety Release Valve™, a device designed to address the dislodgement issue, convened a focus group of vascular access experts through the New Hampshire chapter of the Infusion Nurses Society to discuss dislodgement. Group members agreed that dislodgment was a near-daily problem at their institutions and that better technology was needed to prevent the potentially serious consequences of such a frequent complication. Footnotes
Which complication of intravenous therapy is caused by a dislodge catheter?Infiltration is the leaking of IV fluid into the surrounding tissue. Infiltration is usually caused by the catheter becoming dislodged or by the needle penetrating through the vein.
What happens when an IV is dislodged?The IV can also become dislodged when the site is bumped or IV tubing is accidentally pulled. Dislodgment can cause a catheter to back out, spilling the IV fluids around the IV site instead of in the vein.
What is the most common complication of IV therapy?The most common include:. Phlebitis. Inflammation of the vein. ... . Extravasation. This happens when the liquid in the IV leaks to the tissue surrounding the vein. ... . Air Embolism. This happens when an air bubble (or air bubbles) enters the vein. ... . Hypervolaemia. This is an abnormal increase in blood volume. ... . Infection.. Which is a serious complication of receiving intravenous IV therapy?Complications of gaining I.V. may include infiltration, hematoma, an air embolism, phlebitis, extravascular drug administration, and intraarterial injection. Intraarterial injection is more rare, but as threatening.
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