A Study to Assess The effectiveness of Hot Application on Prevention of Thrombophlebitis among patients with a Peripheral Intravenous Cannula admitted in selected hospitals of Mehsana

 

Kaushal Patidar1, Ankita Trivedi2

1Associate Professor, Joitiba College of Nursing, Bhandu, Gujarat, India.

2Assistant Professor, Joitiba College of Nursing, Bhandu, Gujarat, India.

*Corresponding Author E-mail: kaush776@gmail.com

 

ABSTRACT:

Introduction: Thrombophlebitis occurs when a blood clot causes inflammation in one or more of the veins near the surface of the skin. Damage to a vein can occur as a consequence of indwelling catheters, trauma or the infection of the irritating substances. Objectives: 1. To assess the occurrence of thrombophlebitis among patients with a peripheral intravenous cannula by using modified thrombophlebitis scale in experimental and control group. 2. To assess the effectiveness of hot application on experimental group. 3. To compare the occurrence of thrombophlebitis among patients with an intravenous cannula in experimental and control group. 4. To find out the association between the occurrence of thrombophlebitis with their selected demographic variables. Hypothesis: H0: There will be no significant difference in the occurrence of thrombophlebitis among patients with a peripheral intravenous cannula in experimental group and control group. H1: There will be a significant difference in the occurrence of thrombophlebitis among patients with a peripheral intravenous cannula in experimental group and control group. Design: A quantitative approach using quasi experimental two group post test. Participants: 30 patient in experimental group and 30 patients in control group were selected using Non-Probability convenient sampling technique. Tool: standardized phlebitis scale for using the assess thrombophlebitis among patients with peripheral IV cannula. Results: The mean score of experimental group patients 0.46 was less than control group patients 2.83 and ‘t’ test show that there was a significant difference in the occurrence of thrombophlebitis (‘t’=8.43, p>0.05) between experimental group and control group. Conclusion: From the above findings, it evident that hot application is effective on prevention of thrombophlebitis among patients with peripheral IV cannula.

 

KEYWORDS: Effectiveness, Hot application, Prevention, Thrombophlebitis, Peripheral intravenous cannula.

 

 


INTRODUCTION:

Thrombophlebitis occurs when a blood clot causes inflammation in one or more of the veins near the surface of the skin. Damage to a vein can occur as a consequence of indwelling catheters, trauma or the infection of the irritating substances.

 

Any form of injury to a blood vessel can result in thrombophlebitis. Blood clots are hard and can usually be detected by using palpation. The treatment is limited to application of heat which helps to relieve pain (Bagati and Anjali, 2001).

 

Various factors have been attributed to the development of thrombophlebitis which includes size of catheter material (steel or via flown) length of time the catheter is in a vein, type of solution administered and use of small vein or veins of the lower extremities where blood flow is relatively sluggish. It is implicated that all peripheral IV catheters should be changed every 72 hours (Lohr, 2002).

 

Thrombophlebitis is viewed as a natural consequence of routine intravenous therapy and subcutaneous infiltration of fluid is not always perceived as a serious problem. An infiltration is not the natural consequence of infusion therapy alone and every effort should be made to ensure that the infusion will be completed safely without complication and must use good judgment in site determination, device placement, securing, dressing, care and maintenance (Craven, 2002).

 

A hospital staff nurse probably spends up to two-thirds of their shift on IV-related responsibilities like venipunctures or inserting cannulas, hanging fluids, assessing IV sites and removing IV lines. The frequent use of intravenous catheters carries with it, many potential risks, both mechanical and infections. Not all intravenous complications can be avoided but assessment skills, recognizing their key signs and symptoms, ability to identify problems can minimize risks for patients and will help avoid life-threatening situations (Fabian, 2022;23).

 

The practice of inserting an intravenous cannula into a patient is fast becoming routine in many hospitals. Estimates suggest that 80% of all patients who enter into the health service each year receive IV therapy. Inserting an IV cannula is often a precautionary move aimed at providing quick and efficient access in an emergency (Bohany, 2000).

 

Managing an intravenous therapy regimen has become a common nursing responsibility and it is the part of extended role of nurses. While, due to advances in technology intravenous therapy is now relatively safe, it is still possible for serious complication to arise. but to overlook or underestimate the potential risk of intravenous therapy is to lose site of the aim of therapy, which is to effectively replace fluid and electrolytes without causing the patient discomfort (or) further injury (Lewis et al, 2004).

 

BACK GROUND FOR THE STUDY:

Intravenous therapy is an essential part of clinical care used in a wide variety of health care settings and thus intravenous catheters have become indispensable to clinical practice. Strategies to prevent infection need to be developed and reflect on the advances in technology and delivery of health care. Current guidance recommends a number of strategies to reduce the incidence of catheter-related-bloodstream infections. These include applying the principles of asepsis, the choice of catheter material, the site of insertion and when to replace the equipment used (Castledine, 2002).

An invasive procedure expose patients to infection and thus efficient care is needed when taking care of patients with such procedures. Earlier, nurses were not expected to be involved in inserting intravenous lines but were only responsible for maintaining and preventing complications (J.A, 1992).

 

The use of intravenous device has long been established as a life saving and important part of total patient management. Thus it is implicated that the staffs who are involved in the management of intravenous devices are to base their practice on what is evidence-based and initiate interventions which have been found to be effective in reducing the risks of thrombophlebitis and other hospital-acquired infections (D., 1992).

 

NEED FOR THE STUDY:

In keeping with the latest research, current guidelines from the centre for Disease control and prevention [CDC] state that, even when no problem arise in association with catheter use, peripheral venous catheters should be replaced and sites rotated at least every 96 hrs. The practice of not changing a catheter because the patient shows no signs of complications such as infiltration, thrombophlebitis should be avoided, especially in patients who are neutropenic, immune suppressed or malnourished as these conditions delay the appearance of symptoms (2002).

 

MATERIAL AND METHODS:

Quasi experimental two group post test design were evaluative quantitative research approach was used to assess the effectiveness of hot application on occurrence of thrombophlebities. Non probability convenient sampling techniques were used. Hot applications assess the effectiveness of occurrence of thrombophlebities.

 

Participants:

30 patient in experimental group and 30 patients in control group were selected using Non-Probability convenient sampling technique.

 

Tool:

Standardized phlebitis scale for using the assess thrombophlebitis among patients with peripheral IV cannula.

 

RESULTS:

Demographic data was analyzed using frequency and percentage. Frequencies, percentage, mean, median, mean percentage and standard deviation was used to determine the post test score. The unpaired’ value was computed to show the effectiveness of hot application and chi-square test was done to determine the association between the post test score of effectiveness of hot application with selected demographic variables.

 

Finding related to demographic data:

In experimental group majority 10(33.3%) of patients were in the age group of 18-30 years, the majority patients 16(53.55%) had the history of systematic illness. the majority equal representation of 11(36.7%) patients had the history of food and dust allergy, the majority of patients 17(56.66%) were cannulated with 22G size of cannula, The majority of patients 13(43.33%) were site of IV cannula of median vein, the majority of patients 13(43.44%) were administered with fluids, the majority equal representations of 14(46.66%) patients were the rate of IV infusion 6 hrs and 8 hrs.

 

In control group majority 11(36.66%) of patients were in the age group of 18-30 years, the majority of equal representations of 15(50%) of patients had the history of systematic illness and hereditary illness. the majority 12(40%) had the history of food allergy, the majority of patients 16(53%) were cannulated with 22G size of cannula, the majority of patients 14(46.7%) were site of basilica vein, the majority of patients 15(50%) were administered fluids, the majority of patients 13(43.33%) were the rate of IV infusion 8 hrs.

 

Finding related to post test score:

In the experimental group 17(56.66%) had no sign of the occurrence of thrombophlebitis and 13(43.44%) patients had progressive stage of the occurrence of thrombophlebitis?

 

In the control group 19(63.33%) had progressive stage of occurrence of thrombophlebitis, 10(33.33%) had developed thrpmbophlebitis and 1(3.33%) had no sign of occurrence thrombophlebitis.

 

Finding related to effectiveness of hot application:

The post test mean score of thrombophlebitis in experimental group was 0.46 with S.D 0.57 whereas in the control group the post test mean score 2.83 with S.D 1.44. The mean difference was 2.34 and the calculated unpaired’ value of t = 8.43 was found to be statistically significant at p<0.05 level.

 

Group

Mean

SD

mean diff.

unpaired 't 'test

Experimental

0.46

0.57

2.34

t = 8.43***

Control

2.83

1.44

p = 2.00,S

 

 

Finding related to association between post test score of occurrence of thrombophlebitis with selected   demographic variables:

The demographic variables were not found statistically significant association with the post test score occurrence of thrombophlebitis among patients with peripheral IV cannula with their selected demographic variables in the control group.

 

DISCUSSION:

The present study was conducted to assess effectiveness of hot application on prevention of thrombophlebitis among patients with a peripheral intravenous cannula The investigator had collected the data by standardized phlebitis scale of 30 patient in experimental group and 30 patients in control group. It was revealed that hot application is effective on prevention of thrombophlebitis among patients with peripheral IV cannula.

 

CONCLUSION:

The major conclusion drawn from this study was that hot application found to be effective in prevention of thrombophlebitis of intravenous patients in experimental and control group.

 

REFERENCES:

1.     Bagati and Anjali. Complications of intravenous therapy and prevention. Nursing Journal of India. 2001; 102-103.

2.     Lohr, J. Thromboplebities. Gale Encyclopedia of medicine

3.     Craven, R. H. Fundamental of nursng - Human, Helath, Function . Philadelphia: Lippincott Williams And Wilkins. 2002.

4.     Fabian, B. Intravenous complication: Infiltration. Journal of Infusion Nursing. 2022.

5.     Bohany, J. Nine common complications ans what to do about them. American Journal of Nursing. 2000.

6.     Lewis et al, M. S. Assessment and Managemnet of Clinical Problems. 2004.

7.     Castledine, G.  New initiative to provide evidence- based IV care. British Journal of Nursing. 2002; 11(20).

8.     J.A, W. Preventing infection during IV therapy. Professional Nurse. 1992; 9(6).

9.     D., K. Infection Control in IV therapy. Professional Nurse. 1992; 7(4).

10.   O. G. Guidelines for prevention of intravascular catheter related complication. Center of Disese Controland Prevention. 2002; 51 (6): 18-20.

 

 

 

Received on 31.07.2023        Modified on 17.09.2023

Accepted on 25.10.2023       ©A&V Publications All right reserved

A and V Pub J. of Nursing and Medical Res. 2023; 2(4):95-97.

DOI: 10.52711/jnmr.2023.24