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1.  Routine care of peripheral intravenous catheters versus clinically indicated replacement: randomised controlled trial 
BMJ : British Medical Journal  2008;337(7662):157-160.
Objective To compare routine replacement of intravenous peripheral catheters with replacement only when clinically indicated.
Design Randomised controlled trial.
Setting Tertiary hospital in Australia.
Participants 755 medical and surgical patients: 379 allocated to catheter replacement only when clinically indicated and 376 allocated to routine care of catheter (control group).
Main outcome measure A composite measure of catheter failure resulting from phlebitis or infiltration.
Results Catheters were removed because of phlebitis or infiltration from 123 of 376 (33%) patients in the control group compared with 143 of 379 (38%) patients in the intervention group; the difference was not significant (relative risk 1.15, 95% confidence interval 0.95 to 1.40). When the analysis was based on failure per 1000 device days (number of failures divided by number of days catheterised, divided by 1000), no difference could be detected between the groups (relative risk 0.98, 0.78 to 1.24). Infusion related costs were higher in the control group (mean $A41.02; £19.71; €24.80; $38.55) than intervention group ($A36.40). The rate of phlebitis in both groups was low (4% in intervention group, 3% in control group).
Conclusion Replacing peripheral intravenous catheters when clinically indicated has no effect on the incidence of failure, based on a composite measure of phlebitis or infiltration. Larger trials are needed to test this finding using phlebitis alone as a more clinically meaningful outcome.
Registration number Australian New Zealand Clinical Trials Registry ACTRN12605000147684.
doi:10.1136/bmj.a339
PMCID: PMC2483870  PMID: 18614482
2.  Enhancing Community-Based Disaster Preparedness with Information Technology: Community Disaster Information System 
Disasters  2008;32(1):149-165.
A critical component of community-based disaster preparedness (CBDP) is a local resource database of suppliers providing physical, information and human resources for use in disaster response. Maintenance of such a database can become a collaborative responsibility among community-based non-governmental organizations (NGOs), public, and private organizations in the community. In addition to mobilizing resources, this process raises awareness within the community and aids in assessing local knowledge and resources. This paper presents the results of a pilot study in implementing a community-based resource database through collaboration with local American Red Cross chapters and public and private community organizations. The design of the resource database is described. The resource database is accessible both using the Internet and offline using laptops and handheld PDAs to support disaster response. The study concludes that CBDP is strengthened through a combination of appropriate information technology and collaborative relationships between NGOs and community-based organizations.
doi:10.1111/j.1467-7717.2007.01032.x
PMCID: PMC2239245  PMID: 18217923
CBDP; NGOs; emergency preparedness; information technology
3.  Routine care of peripheral intravenous catheters versus clinically indicated replacement: randomised controlled trial 
Objective To compare routine replacement of intravenous peripheral catheters with replacement only when clinically indicated.
Design Randomised controlled trial.
Setting Tertiary hospital in Australia.
Participants 755 medical and surgical patients: 379 allocated to catheter replacement only when clinically indicated and 376 allocated to routine care of catheter (control group).
Main outcome measure A composite measure of catheter failure resulting from phlebitis or infiltration.
Results Catheters were removed because of phlebitis or infiltration from 123 of 376 (33%) patients in the control group compared with 143 of 379 (38%) patients in the intervention group; the difference was not significant (relative risk 1.15, 95% confidence interval 0.95 to 1.40). When the analysis was based on failure per 1000 device days (number of failures divided by number of days catheterised, divided by 1000), no difference could be detected between the groups (relative risk 0.98, 0.78 to 1.24). Infusion related costs were higher in the control group (mean $A41.02; £19.71; €24.80; $38.55) than intervention group ($A36.40). The rate of phlebitis in both groups was low (4% in intervention group, 3% in control group).
Conclusion Replacing peripheral intravenous catheters when clinically indicated has no effect on the incidence of failure, based on a composite measure of phlebitis or infiltration. Larger trials are needed to test this finding using phlebitis alone as a more clinically meaningful outcome.
Registration number Australian New Zealand Clinical Trials Registry ACTRN12605000147684.
doi:10.1136/bmj.a339
PMCID: PMC2483870  PMID: 18614482

Results 1-3 (3)