Reducing cannula complications in adults : routine against clinically indicated replacement

Abstract

Scientific evidence had proven that cannulas could remain in place more than three days without developing complications, although the Centre of Disease guideline contradicts this statement thus the dissertation will be done so as to evaluate the debate. Question: Does routine replacement of peripheral venous cannula in adults result in less complications than clinical-indicated replacement? Population: Adults in-patients in general wards having a peripheral venous cannula in situ and not immunosuppressed. Intervention: Routine replacement of cannula. Comparison: Replacement when complications arise. Outcome: The method of replacement of cannula that would reduce the incidence of peripheral cannula complications, hospitalisation and healthcare costs. Method of appraisal: CASP tools for systematic reviews and randomised controlled trials. Result: The risk of developing complication was the same in routine and clinical-indicated replacement of cannula however healthcare costs were higher when cannula was replaced routinely. Conclusion: Studies showed that replacement of peripheral intravenous cannula is decided on clinical-indication is more beneficial for the patient, staff and healthcare organisations. Implications and recommendations: When there is compliance to the recent local policy for peripheral venous cannula care especially compliance to cannula assessment, replacement of cannula should be changed to replacement based on clinical-indication as patients are spared pain from venepuncture, less work-load for staff and less health-care costs. Limited research was found from the European countries hence the suggested countries should develop more research on this topic so as to develop their recommendation on this subject which would be more appropriate for the local setting.