THE EFFECT OF INTRINSIC AND EXTRINSIC FACTORS TO THE PHLEBITIS DEVELOPMENT IN PATIENT WITH INTRA VENOUS THERAPY IN EMERGENCY ROOM IMMANUEL HOSPITAL, BANDUNG

Dalia Novitasari

Abstract


Background: Phlebitis is a secondary infection that causes inflammation of the vein, because of chemical irritation and irritation caused by IV procedures. Report from Ministry of Health Republic of Indonesia showed that the number of phlebitis incident acoording to distribution of circulation diseases in Indonesia is 744 patients (17,11%). Data from Immanuel Hospital (2011) showed an 1.17% increasing rate of phlebitis every trimester. Aim: This study aimed to recognize the effect of intrinsic and extrinsic factors to the phlebitis development in patient with IV therapy at Emergency Room Immanuel Hospital Bandung. Materials and Method: This study was a quantitative research, an analytical descriptive, using prospective design. Sample selection method was consecutive sampling to all emergency room patients with IV installation. Sample analysis was conducted on the third day using VIP (Visual Infusion Phlebitis) Score. Results: The result of this study showed that 19.2% of patients with IV therapy in emergency room has developed phlebitis, while 80.8% others were free from phlebitis. Statistic output from intrinsic factors analysis using Chi Square Test with level of confidence 95% showed that there were significant effect of age (p=0.026), gender (p=0.038) and accompanying disease (p=0.010) to develop phlebitis. From extrinsic factors analysis, in terms of devices there were significant effect of the injection drug pH (p=0.001) to development of phlebitis, while extrinsic factors, in terms of nurse as health worker in conducting IV, showed that work experience (p=0.001) and nurse’s attitude (p=0.001) effect the development of phlebitis. In the binary logistic regression test, there was a significant relationship between phlebitis and the pH of injection drug with p value = 0.001 (OR 4,98 CI 95%), accompanying disease with p value = 0,006 (OR 4,303 CI 95%), patient’s gender with p value = 0,013 (OR 3,41 CI 95%) and nurse’s attitude with p value = 0,017 (OR 3,07 CI 95%). Conclusion: Some of the data from this research indicated that at the most the intrinsic and extrinsic factors affected the phlebitis development. The effect of age, gender, and accompanying disease were the factors that was difficult to change, but it can be anticipated with the nurse’s knowledge associated with the location and techniques of installing the IV correctly. Other things that affect the phlebitis development were the external factors, including the pH of injection drug fluid, nurse’s work experience and nurse’s attitude. The pH of injection drug fluid certainly can’t be changed, because every doctor had their own consideration in determining which drugs given to the patient. This can be anticipated by selection of the IV location at the larger vein, in addition to mix the injection drug fluid properly. Nurse's attitude was a factor that can be changed through various activities such as proper hand washing training and awareness to obey the Standard Operating Procedures.


Keywords


Phlebitis, Infusion Therapy, Infection of the hospital, VIPScore

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