Efficacy and safety of a two-step method of skin preparation for peripheral intravenous catheter insertion - a prospective multicentre randomised trial

INTERVENTION: With the intention of encouraging compliance with the recommendations, we have developed a simplified, effective method for skin preparation for the insertion of PVCs, involving two successive swabbings with alcoholic antiseptic imbibed compresses. There will be two procedures tested in this trial: 1. The two‐step procedure 2. The standard four‐step procedure PVCs were inserted and maintained by nursing staff. The investigators were responsible for checking that the prescribed skin preparation protocol was adhered to and for collecting data concerning possible confounding factors. These included the age of the patient, immunosuppression, nature of the catheter, number of manipulations per day, duration of catheterisation and the nature of the perfused solutes. Inspection of the insertion site is a key part of nursing care. The patients were monitored daily throughout the time of perfusion, until withdrawal of the catheter, for a maximum of 72 hours. CONDITION: Catheter‐related septic thrombophlebitis ; Circulatory System ; Thrombophlebitis PRIMARY OUTCOME: The appearance of precursor signs of infection at the insertion site, as evaluated according to the Maddox scale. The nurses were trained in the use of this scale before the start of the study. SECONDARY OUTCOME: No secondary outcome measures INCLUSION CRITERIA: 1. Hospitalised, consenting adults aged over 18 years 2. Male or female 3. Requiring the insertion of a continuous PVC with a treatment duration of more than 48 hours 4. Those for whom either skin preparation procedure could be used