Comparaing the effect of Nitroglycerin and Clobetazol Ointments on Prevention of Superficial Intravenous Catheter Induced Phlebitis

Document Type: Original Quantitative and Qualitative Research Paper

Authors

1 Postgraduate student, Master of critical nursing Sciences, Department of Nursing, School of Nursing and Midwifery, Lorestan University of medical sciences,Khoramabad, Iran

2 Instructor of nursing, Department of Nursing, School of Nursing and Midwifery, Lorestan University of Medical Sciences, Khoramabad, Iran

3 Assistant Professor in nursing, Department of Nursing, School of Nursing and Midwifery, Arak University of Medical Sciences, Arak, Iran

4 Assistant Professor in Community Medicine, School of Medicine, Lorestan University of Medical Sciences, Khoramabad, Iran

Abstract

Background: Although intravenous injection is nowadays one of the common invasive procedures in medical care, but like any other procedure, it has a lot of side effects. Phlebitis is the most common complication and one of the therapeutic aims is to prevent it.
Aim: The aim of this study was to compair the effect of Clobetasol with Nitroglycerin ointment on the prevention of superficial IV Catheter induced phlebitis.
Methods: This clinical trial study was conducted on 144 patients admitted in men surgery ward in Arak Valiasr hospital in 1392. Patients were randomly allocated into three groups: Group A (Clobetasol), Group B (NTG) and Group C (Control). Severity of phlebitis was measured using the standard visual rating scale. In intervention groups, after venipuncture, ointment were administered on the distal portion of IVcatheter and the area was dressed. The venipuncture area was assessed 24, 48 and 72 (hrs) after venipuncture. Data were analyzed by chi-square, Fisher's exact and Kruskal-Wallis statistical tests and using spss19.
Results: There was no significant difference among three groups in terms of severity of catheter induced phlebitis in the first and second measurements. In the third measurement there was a significant difference among intervention and control groups (P < 0/007) and the severity of catheter induced phlebitis was reduced more in NTG group comparing Clobetasol group.
Conclusion: The use of Nitroglycerin in prevention of superficial, IVcatheter induced phlebitis is more effective than Clobetasol. It is suggested that Nitroglycerin can be administered to prevent phlebitis in patients who need to have IVcatheter for a long time (over 48 hours).

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1. Borzo S, Salavati M, Zandieh M, Zamanpour A. The Effect of Sterilegauze Bandage on Preventing of Phlebitisand local Infections due to Intravenous Catheter. JGUM.2003; 5(12):71-6 (Persian).

2. Sarani B, Ahmadi F, Dabiri S. Comparison of Alcohol, Betadineand Alcohol-Iodine in the Incidence of Complications Venous Catheter. JANM.2000:17(Persian).

3. RazaviM, etal. Assess of Superficial Thrombophlebitis from the use of Intravascular Devices and its Influencing Factors in Patients at Shariati Hospital. First National Congress of Public Health and Preventive Medicine. December of 2000 (Persian).

4. Hockenberry MJ. Wilson d .WS. Nursing Care of Infant and Children. 9th. St. Louis. Missouri: Mosby 2011.

5. Koh DB. Exploration of the Patterns of Microbial Colonization of Intravascular Devices in Severely Ill Patient .2011eprints.utas.edu.au/12482.

6. Behrman RE. Klieg man, RM. Jason, HB. Nelsons text book of Pediatrics .Philadelphia: WB. Saunders co, 2008.45 (18).

7. Foster L, Wallis m, Paterson B, Tames H .A Descriptive Study of Peripheral Intravenous Catheters in Patients Admitted to a Pediatric Unit in One Australian Hospital. JIN. 2002. 25)3(:159-67.

8. Hadaway L. JIN, 2012 .35(4):230-40.

9. Potter PA, Perry AG. Basic Nursing – A Critical Thinking Approach. 4th ed. Philadelphia: Mosby Company; 2004:856-81.

10. Taghinejad H, Asadizaker M, Tabesh H. (A Comparative Analysis of the Effects of Betadine and Alcohol as Sterilizers on the Complications of Intravenous Catheters. JIU M2005; 13(4): 10-6 (Persian).

11. DastgerdiM. Prevalence of Complications in Hospitalized patients by Intravenous Injection of Medical Sciences.MS Thesis.Tarbiat Modarres University, 1900:5-2 (Persian).

12. AslaniY.Asses of Phlebitis Caused by Intravenous Catheter in Internal and Surgical Patients Hospitalizedin Kashan and Hajar Hospitals. JSUM.1999; 3:44-8 (Persian).

13. GhadamiA. Comparison of Prevalence and Risk of Phlebitis in Patients with Intravascular Devices Interms of in Sertiontime 24, 48 ,72 and 96 hours.AMUJ 2000; 3(4):27-30 (Persian).

14. Tushida T (et al). The Effectiveness of a Nurse Initiated Intervention to Reduce Catheter-Associated Blood Stream Infections in an Urban Acute Hospital: an Intervention Study with Before and After Comparison. IJNS. 2007, pp: 44.

15. Webster J, Gillies D, O’Riordan E, Sherriff KL, Rickard CM. Gauze and Tape and Transparent Polyurethane Dressings for Central Venous Catheters (Review).2011: 4

16. Grady NP, Alexander M, Dellenger EP. Guidelines for the Prevention of Intravascular Catheter-Related Infections. MMWR. 2002; 51(RR10): 1-26.

17. Waitt C et al. Intravenous Therapy. Postgraduate Medical Journal.2004; 80(939):1-6.            

18. Singhal AK et al. Recent Advances in Management of Intravascular Catheter Related Infections. IJMPO.2004; 26(1):31-40.       

19. Rigdon Ro. Protocols for the Prevention of Intravascular Device – Related Infections. Critical Care Nursing. 2001; 24: 39-47.

20. Robert A. Heparin Sodium Versuse 0.9% Sodium Chloride Injection for Maintaining Patency of Indwelling Intermittent Infusion Devices. Clinical Pharmacy. 1988; 7: 439-43.

21. Khawaja HT, James J, Payne J. Survival of Peripheral Intravenous Infusion. BMJ. 1992;

      304(18): 1053-4.

22. Callaghan S, CopnellB, jahson L. Comparison of Two Methods of Peripheral Intravenous Cannula Securement in the Pediatric Setting.JIN. July/August 2002. 20(4):256-64.

23. Bayati A. Asses of Predisposing Factors of Phlebitis in Children Receiving Intravenous Fluid in Hospitalized Covered by Tehran University. JAD. Winter1999  (Persian).

24. KaradagA, Gorgulu S. Devising an Intravenous Fluid Therapy Protocol and Compliance of Nurses with the Protocol. JIN2000; 23 (4): 232-8.

25. Roberts Gw, Holmes MD, Staugas RE, Day RA, Finlay CF, Pitcher A. Peripheral Intravenous line Survival and Phlebitis Prevention in Patients Receiving Intravenous Antibiotic: Heparin / Hydrocortisone Versus in Line Filters. AnnPharmacother1994; 28 (1):6-11.

26. Heker JF. Potential for Extending Survival of Peripheral Intravenous Infusions. Br Med J 1992; 304: 619-24.

27. Becherucci A, D Bagilet, J Marenghini, M Diab& H Biancardi: (Effect of Topical and Oral Diclofenac on Superficial Thrombophlebitis Caused on Superficial Thrombophlebitis Caused by Intravenous Infusion). Med Clin (Barc). 2000.114(10):371-3

28. Bolander VB, Sornson, Luckman S. Basic Nuring a Psychophisiologic Approch. 3th edition. Philadelphia. WB.Saunders Co. 1994; 985-355.

29. Katzung BG. Basic and Clinical Pharmacology. 11th ed. California Appelton&Lange; 2009:182 349.

30. Khawaja HT, James J, Payne J. Survival of Peripheral Intravenous Infusion. BMJ. 1992; 304(18): 1053-4.

31. Avazeh A, Elahi N, AsadiZaker M, Rasekh A, Hoseini F. Effect of Topical Nitroglycerinon the Incidence and Severity of Phlebitis Caused by Intravenous Catheters. JZUM.2003; 47:15-20 (Persian).

32. Saleh Moghadam A, VahedianAzimi A, RezaieAdariani M. Effect of 2% Nitroglycerin Ointment on the Severity of Phlebitis Induced by Intravenous Catheter. J ShahrekordUnivMed.2009; 11(2):22-9 (Persian).

33. Tjon JA, Ansani NT. Transdermal Nitroglycerin for the Prevention of Intravenous Infusion Failure due to Phlebitis and Extravasation. Ann Pharmacother2000; 34: 1189-92.

34. Clobetasol 17-Propionate Cream as an Effective Preventive Treatment for Drug Induced Superficial Thrombophlebitis. Scand. J. Lab. Anim. Sci. 2009 .36(2).

35. Effect of Corticosteroids on Phlebitis Induced by Intravenous Infusion of Antineoplastic Agents in Rabbits. Int J Med Sci. 2009; 6(4): 218–223Published online 2009 August 6.