RESEARCH PRESENTATION PROJECT

Title  Members
 A study to assess the knowledge  Madiha Zaib
regarding thrombophlebitis  Iqra Rehmat
among nursing students at  MShahbaz
Jinnah postgraduate medical Khan
center, Karachi.
 Supervisor
 Mr. Sir Raja

1
 SEQUENCE OF PRESENTATION
 Introduction  Conclusion
 Objectives of the study  Recommendation
 Methods and Material  References
 Results
 Discussion
 Limitation of the study
 Strength of the study

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 INTRODUCTION
 Peripheral intravenous cannulation is the most common source of
Infection. Peripheral intravenous cannulation is an invasive procedure
performed in hospitalized patients where the patient skin is punctured
with a needle to allow insertion of a temporary plastic tube into a vein.
 It is an integral part of nursing practice in all the healthcare institutions
which is done for different purposes like administration of medication,
IV infusion and blood,
 It is kept for the different duration of time depending on patients
condition with a potential risk of microbial growth.[1]
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 CONT..
 the incidences of local or blood stream
infections are related to IV therapy.
 This problem occurs due to the poor
practices of intravenous cannulation or
therapy [5,6].
 Peripheral intravenous cannulation is the
most common source of infection due to
the migration of skin flora on the site of
insertion into the cutaneous tract of
cannula with outer surface of catheter [8].

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CONT..
 In today’s world of health care, nurses must possess up to date
knowledge while practicing intravenous therapy for safe nursing
practice as well as excellent quality of care.[12,13]
 Nurses are responsible for provision of safe, patient centered
and effective care to the patients.[14]
 To minimize the severity of complications, puncture site must be
constantly monitored for early identification of signs. In addition,
hands should be decontaminated properly before gathering
equipment, palpation of the veins, cannulation and placing
gloves on hand, repeat it after removing gloves.[15,16]

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 OBJECTIVES OF THE STUDY
 To assess the knowledge regarding thrombophlebitis
among nurses in tertiary care hospital.

 To determine association between demographic variables

and knowledge regarding thrombophlebitis among nurses
in tertiary care hospital.

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RESEARCH DESIGN

Cross sectional study Design were used in this study

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STUDY SETTING

Study was conducted at College of Nursing Jinnah

Postgraduate
Medical Center Karachi.

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STUDY DURATION

Duration of the study was three months from April to

June 2019.

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 Inclusion Criteria
Post RN BScN students of all
semesters studying at College
of Nursing at Jinnah
Postgraduate Medical center
Exclusion Criteria
Students who were not
willing to participate in the
study on voluntary basis
were excluded
from the study.
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SAMPLE SIZE

100 Post RN BScN students from Jinnah Postgraduate

Medical Center Karachi who were working in
different tertiary hospitals.

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SAMPLING TECHNIQUE

Non-probability convenient sampling was used in this

study

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 LIMITATION / WEAKNESS OF THE STUDY
WEAKNESS OF STUDY WAS THAT WITH NON
PROBABILITY CONVENIENT SAMPLING
IT IS DIFFICULT TO GENERALIZE TO ALL STUDENTS

Strength of the study

This is first ever study conducted to assess the
knowledge regarding thrombophlebitis among
13 nurses in college of nursing jpmc.
 STATISTICAL ANALYSIS
 Data was entered & analyzed by SPSS version 16.0

 Data was presented in mean ± SD for all continuous variables, while

frequency and percentage for all qualitative variables.

 Chi-squire was used to identify the significance association with

outcome variable. Level of significance was considered 0.05.

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 CHAPTER 04
Results
Demographic Information
In this cross sectional study
table.1 shows that
 26% were male nurses and
 74% were female nurses and
 table.2 shows that
 27% were in age group 21-25 years,
 51% nurses were in 26-30 years,
 22% nurses were in 31-35 years age group. 15
 FIGURE. 1, 2 AND 3
Gender

Duty Shift
Age

Frequency Percent

Valid Morning
41 41.0
Frequency Percent
Frequency Percent Evening
Valid Male 27 27.0
Valid 21-25
26 26.0 27 27.0
Night
32 32.0
26-30
Female 51 51.0 Total
74 74.0
31-35
22 22.0
Total 100 100.0

Total
100 100.0
100 100.0
16
17 39% nurses were working in general ward,35% were working
is emergency ward,19% in ICU and 7% in CCU.
 Table.5
Responses for what is thrombitis were as inflammation of cell (24%), inflammation of mouth(16%),inflammation of vein
(53%) and inflammation of gum (7%).
Table.6
63% nurses said that thrombosis is the formation of a blood clot inside a blood vessel and 37% nurses reported it is
accumulation of blood in vein.
Thrombosis is
Thrombolitis is

Frequency Percent Frequency Percent

Valid Inflammation of cell Valid formation of a blood clot

24 24.0 inside a blood vessel

Inflammation of mouth 63 63.0

16 16.0

Inflammation of vein
53 53.0
Accumulation of blood in
Inflammation of gum vein
7 7.0 37 37.0

Total
100 100.0
Total
18
100 100.0
 Table.7
30% nurses said cellulitis is known as an inflammation of vein followed by inflammation of skin (26%), inflammation of
bone (16%), inflammation of tissue (28%).
Table.8
For drug which prevents a thrombus formation, nurses responded as antibiotic (19%),antidepressive
(10%),antiplatelates (64%),and antacid (7%)

Cellulitis is known as
A drug which prevents a thrombus formation is

Frequency Percent

Valid An inflammation of vein Frequency Percent

30 30.0
Valid Antibiotic
19 19.0
An inflammation of skin
26 26.0 Antidepressive
10 10.0

An inflammation of bone Antiplatelates

16 16.0 64 64.0

Antacid
An inflammation of tissue 7 7.0
28 28.0
Total
Total 100 100.0
100 19
100.0
Table.09
if there is a sign of thrombophlebitis then nurses should immediately elevate hand (42%),push iv bolus (57%) and massage
(1%)
Table.10
For elevation of affected part 27% nurses said improves circulation followed by improves cell growth (20%),reduces
circulation (21%).

Elevation of affected part helps

Frequency Percent

Valid Elevate hand Frequency Percent

42 42.0
Valid improve circulaion 27 27.0
push an IV bolus
57 57.0 improve cell
growth 20 20.0
Massage the area

1 1.0 reduce circulation 21 21.0

All of above 32 32.0

Total
100 100.0 Total
100 100.0 20
 Table .11
Standard duration of changing intravenous device should be 70-90 hours (48%),80-90 hours (36%),72-120 hours (16%).
Table.12
The dressing over the intravenous device should be as transparent (35%),non transparent (51%),semitransparent (14%)

standard duration of changing intravenous device should be The dressing over the intravenous device should be

Frequency Percent Frequency Percent

Valid 70-90 hours Valid Transparent

48 48.0 35 35.0

80-90 hours Non transparent

36 36.0 51 51.0

72-120 hours semitransparent

16 16.0 14 14.0

Total Total
100 100.0 100 100.0 21
 Table.21
Measurement scale used for thrombophlebitis was reported as vein scale (8%),thrombo scale (39%),vision infusion
phlebitis scale (17%),pain scale (36%)
Table.22
As per scale grade of 0 indicates was reported as IV site is healthy (18%), presence of thrombophlebitis (33%),swelling
(36%) and erythema (13%)

Measurement scale used for thrombophlebitis is As per scale of thrombophlebitis grade of 0 indicates

Frequenc
Frequency Percent y Percent

Valid vein scale 8 8.0 Valid IV site is healthy 18 18.0

thrombo scale 39 39.0 presence of

thrombophlebitis 33 33.0
visual infusion phlebitis
scale 17 17.0
swelling 36 36.0

pain scale 36 36.0 Erythema 13 13.0

Total 100 100.0 Total 100 100.0 22

23 Nurses reported that cannula should be changed if
pain along path of cannula (51%),erythema
(22%),swelling (14%),slight pain near iv site (13%).
24

For an example of anticoagulant drug nurses reported as

paracetamol (2%), heparin (56%),vancomycin
(24%),haloperidol (18%).
 Table.23
Association between demographic variables knowledge regarding thrombophlebitis
No statistical association has been found between demographic variables and knowledge regarding thrombophlebitis among nurses.

Variables Chi-square value P value

Age 3.79 0.28

Professional qualification 2.7 0.84

Working experience 2.16 0.90

Working unit 12.4 0.18

Duty shift 8.6 0.19

Nature of duty 9.8 0.36

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 DISCUSSION
 In this study 53% of nurses had responded that
thrombophlebitis is an inflammation of vein which shows that
half the nurses have correct knowledge and half the nurses
have poor knowledge. Similarly, another study has also
validated that half the nurses (54%) had poor knowledge of
thrombophlebitis. [10],
 A study reported that 67% patients developed signs of phlebitis
that indicate poor practices by the nurses. [14]
 16% nurses said before cannula insertion clean the site with
alcohol or povidone. if there is a sign of thrombophlebitis then
nurses should immediately elevate hand(42%),pouch iv bolus
(51%) 26
 CONT..
 Another study validated that, it is important to select the
appropriate solution. Comparing the effectiveness and safety
of 0.9% sodium chloride solution versus heparin saline solution
as flushing and locking solutions for peripheral intravenous
access devices in a prospective controlled trial, Wang et. al.,
22 concluded that both agents are equally effective and
safe.[16]
 97% of respondents have knowledge that thrombophlebitis
and infection are the common complications of IV cannulation.
 Similarly, 75.5% of respondents were aware of the influences
of environmental cleanliness on IV site infection.
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 CONT..

 However, no statistical significance was found between

demographic variables and knowledge of nurses regarding
thrombophlebitis in this sample. But other study reported that
some variables include: age, gender statistically significant
with cannulation.
 Incidence of phlebitis increases with age; with most studies
showing that obvious signs of phlebitis were present in
approximately 50% of patients over the age of 60.[17]

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 CONCLUSION
 In this study most nurses were having a good knowledge of
caring and maintaining of peripheral IV cannulation but there
were still some nurses who did not have proper knowledge
and experience for using IV cannulation which could be a
potential risk factor for patient safety.
 Their knowledge towards care and maintenance of IV
cannula was very limited which might result in practicing
incorrect method.

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 RECOMMENDATION
 More analytic studies may be conducted at other tertiary
care hospitals of karachi Pakistan to assess the knowledge
regarding thrombophlebitis among nurses to develop a
policy for safety guidelines regarding cannulation practices.

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