Intravenous Therapy Team and Peripheral

\s=b\A prospective controlled trial was conducted on four similar inpatient medical wards to test the hypothesis that a trained Intravenous therapy (IVT) team would substantially reduce the incidence of peripheral intravenous (IV) catheter\p=m-\ related complications. We followed 863 IV catheters. The overall incidence of phlebitis in the ward staff\p=m-\maintainedIV catheters was 32% as compared with 15% for those maintained by the IVT team. The incidence of two more serious complications (cellulitis and suppurative phlebitis) was reduced tenfold from 2.1% to 0.2%. We conclude that an IVT team can substantially reduce the iatrogenic complications related to IV catheters. (Arch Intern Med 1984;144:1191-1194) Tntravenous (IV) infusion of fluids, blood products, drugs, and nutrients is now one of the most important and frequently used therapies for hospitalized patients. Despite the many benefits of IV therapy (IVT), physicians have long been aware of a wide range of iatrogenic complications ranging from phlebitis to sepsis and death. The incidence of phlebitis has been reported to be in the range of 25% to 35%.13 lb minimize these complications, the Centers for Disease Control (CDC), Atlanta, have established guidelines for IV catheter maintenance.4 One of these guidelines includes a "weak" recommendation for the establishment of a profession¬ ally trained IVT team to insert and maintain IV catheters. The recommendation is weak because of the absence of good data. In sharp contrast, other workers believe that an IVT team has the potential to substantially reduce the incidence of complications because of the low complication rate in uncon¬ trolled trials.5 Several studies have discussed the effectiveness of an IVT team in reducing complications, but most were retrospective or lacked controls.1,3,6,6 One small prospective controlled study showed a reduction in phlebitis with an IVT team, but also showed a higher frequency of infiltration, which the authors