It’s who looks after the catheters that countsBMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a1001 (Published 28 July 2008) Cite this as: BMJ 2008;337:a1001
- Steven J Kennish, specialist registrar in radiology1
Maki asserts that the incidence of intravenous catheter complications is greatly reduced when highly experienced nurses insert catheters.1 The single reference provided to support this statement makes interesting reading.2 This randomised controlled trial compares complications in two main groups of patients: those who are cannulated by house doctors and followed up by ward staff and those who are under the care of the intravenous therapy team. The latter group are checked daily for complications by experienced nurses, but their cannulas are inserted by doctors and nurses in similar numbers. The intravenous therapy nurses do a sterling job it seems between 9 am and 5 pm, but in time honoured tradition it is the house doctors who perform all intravenous cannulation between 5 pm and 9 am and at weekends.
The complication rates for patients who are subsequently followed up by the intravenous therapy nurses showed a slightly higher complication rate for the nurse inserted cannulas (9.3%) than the doctor inserted cannulas (6%).2 The three episodes of line related sepsis in the house doctor group (not undergoing routine daily review) seem to be related to duration in situ rather than any other factor. One of these three cannulas was actually inserted by paramedics rather than the house doctors.
The paper clearly states that the maintenance and timely removal of intravenous catheters is more important than the specific personnel inserting the catheters in determining the occurrence of complications.
It is frustrating to see an editorial make a rather sweeping statement that is not supported by the relevant citation.
Cite this as: BMJ 2008;337:a1001
Competing interests: None declared.