Introduction

A complication is an event or occurrence that is associated with a disease or a healthcare

intervention, is a departure from the desired course of events, and may cause, or be associated with,

suboptimal outcome.19

The common complications occurs as a result of negligence of health professionals can be

adverse drug effects, hospital-based infections ,infections at the site of surgery or trauma ,nerve injury that

occurred from an operation ,urinary infections obtained during the course of the hospital stay ,taking a fall

during the course of stay ,pressure sores. 19

Over 90% of hospitalized patients will receive some form of intravenous therapy during the

course of their care, and intravenous medication administration represents one of the highest-risk, most

invasive procedures performed by nurses. And thrombophlebitis has become one of the common

complications of IV cannulation.3

Thrombophlebitis is the formation of a thrombus (clot) in association with an inflammation of

vein with blood clot formation inside the vein at the site of the inflammation. Thrombophlebitis also is

known as phlebitis, phlebothrombosis, and venous thrombosis. It is evidenced by localised pain redness,

warmth and swelling around the insertion site or along the path of vein , immobility of extremity because

of discomfort and swelling sluggish flow rate, fever malaise and leukocytosis. 1 Commented [A1]: 1.Suzanne C Smeltzer, Brenda G.
Bare, Janice L. Hinkle, Kerry H Cheever. “Brunner and
Suddarth's textbook of medical-surgical nursing”. Tenth
Edition. Lippincott Williams & Wilkins, page no.291-292
Thrombophlebitis can be classified as either superficial or deep ,in about 55% of all patients

receiving I.V therapy, superficial thrombophlebitis develops and in at least 5% of all surgical patients deep

vein thrombophlebitis develops .superficial thrombophlebitis is often of minor significance and it is treated

with anti-inflammatory agents and warm compression .Deep vein thrombosis is of greater significance and
can result in embolism of thrombi from deep vein to the lungs .This can be fatal and at the least results in

prolonged hospitalisation .1 Commented [A2]: 2.Suzanne C Smeltzer, Brenda G.

Bare, Janice L. Hinkle, Kerry H Cheever. “Brunner and
Suddarth's textbook of medical-surgical nursing”. Tenth
There are multiple risk factors for the development of thrombophlebitis. The longer duration of Edition. Lippincott Williams & Wilkins, page no.291-292

cannulation is proportional to the risk of thrombophlebitis. Catheters placed in the veins that overlay joints

are more likely to cause thrombophlebitis, as motion of the joint can cause frictional trauma between the

endothelium and the catheter. Stagnant blood flow in the lower extremities makes veins in this location

more likely to develop thrombophlebitis. Numerous intravenous fluid solutions, such as potassium chloride,

barbiturates, phenytoin, and chemotherapeutic agents, are known to cause endothelial damage and

inflammation. Finally, poor technique and multiple attempts lead to vascular damage and

thrombophlebitis.4 Commented [A3]:

3.Springhouse, “Handbook of Diseases”, Ninth Edition,
Lippincott Williams & Wilkins,2003,page no.179
Any nurse who commences a prescribed infusion as part of her daily clinical practices must

have under taken specialist training and assessment of competence in line with the organization protocol in

order to minimize the risk. Nurses must recognize the nursing protocol and how they can close the

knowledge practice gap .Development of research based protocols for the care of patients may be more

beneficial to provide improved health care.3 Commented [A4]: 4.

5.
6.Dawn Brittan (2007)”Clinical Guideline for Periph3ral
Intra venous Cannulation, 2Ed. South Gloucestershire
Primary Care Trust, London, Page no.1-11.
7.

Thrombophlebitis is the formation of a thrombus (clot) in association with an inflammation of vein

with blood clot formation inside the vein at the site of the inflammation. Thrombophlebitis is also known

as phlebitis, phlebothrombosis or venous thrombosis. It is evidenced by localized pain redness, warmth

and swelling around the insertion site or along the path of vein, immobility of extremity because of

discomfort and swelling sluggish flow rate, fever, malaise and leukocytosis. Thrombophlebitis can be

classified as either superficial or deep; in about 55% of all patients receiving IV therapies develops

superficial thrombophlebitis and at least in 5% of all surgical patients develop deep vein thrombophlebitis.2 Commented [A5]: 1.Suzanne C Smeltzer, Brenda G.
Bare, Janice L. Hinkle, Kerry H Cheever. “Brunner and
Suddarth's textbook of medical-surgical nursing”. Tenth
Edition. Lippincott Williams & Wilkins, page no.291-292,
There are multiple risk factors for the development of thrombophlebitis like size of the catheter, 250-251.

catheter placed in the veins that overlay joints, stagnant blood flow in the lower extremities etc. Fluids like

potassium chloride, barbiturates, phenytoin and chemotherapeutic agents are known to cause endothelial
damage and inflammation. The release of inflammatory mediators such as histamine, serotonin can reduce

cell tolerance to various stimuli, which can lead to venous inflammation. Finally, poor technique and

multiple attempts lead to vascular damage and thrombophlebitis. It is implicated that all peripheral IV

catheters should be changed every 72 hours.3 Commented [A6]: Springhouse, “Handbook of Diseases”,
Ninth Edition, Lippincott Williams &Wilkins, 2003, page
no.179