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Management of Superficial Phlebitis: Tradition v. Science
Management of Superficial Phlebitis: Tradition v. Science
Tradition v. Science
Isabel Ng Hui Leng Senior Staff Nurse (Research) Nursing Service 23 Sep 2011
Past
Present
Inflammatory process that arises from the sensitization of the vascular endothelium Mechanical, chemical Affect between 20% to 80% of patients on infusion therapy Phlebitis Rating Scale (MOH CPG 1/2002)
Primary hypothesis
Active ingredient: MPS (mucopolysaccharide) For the treatment of bruises, swelling, scars and various inflammatory conditions of the veins. Inhibits inflammation, relieves pain and tension in the afflicted area and shortens the duration of the problem. Helps with inflamed veins to treat various inflammatory conditions of the veins requiring medical supervision
To reduce swelling
Case definition
Method: Population
Inclusion criteria
Consecutive cases of redness associated with peripheral catheters between Dec 2009 to Feb 2010
Exclusion criteria
Thrombophlebitis Extravasations Presence of pus at the affected site Fragile skin Known sensitivity to the topical applications
Method: Intervention
No application Therapy Observe the affected area closely at each shift
GMS Therapy
Soften the magnesium sulphate paste by placing the bottle in a cup of hot water Apply the liquid paste generously with a spatula on the affected area Dress it with gauze and bandage Daily dressing
Hirudoid Therapy
Squeeze adequate Hirudoid cream unto the affected area Gently rub the cream (with the gloved finger) into the skin until it disappears Be careful not to apply the cream into the catheter puncture site 12 hourly dressing
The principal nurse will escalate to the team physician if the affected area worsens
Method
Randomization
Allocation
Concealment
Method: Procedure
1. 2. 3.
4.
Method: Procedure
5.
1.
2.
6.
1.
2. 3.
7.
P=0.83
P=0.61
P=0.09
p75 p50
P=0.38
p25
P=0.18
Discussion
Selection bias
Not all consecutive cases were included (same for all groups) Difficulty to trace the area very accurately when the redness is subsiding (same for all groups) Specific IV that contributes to the healing progress (continuous/bolus at the same time) Difficult to follow up patient post discharge (same for all groups)
Systematic error
Possible confounding
Missing data
Practice change
Credits
APN Kamilah Jabin SNM Koh Bee Hoon SSN Phyllis Wong SSN Isabel Ng Hui Leng
With support from TTSH Nursing Service and A/Prof Tay Jam Chin
The project would not be possible with our ENs who labored with us 24/7 on data collection and counting of millions of squares!