The influence of hand hygiene prior to insertion of peripheral venous catheters on the incidence of complications

Using two studies of a simple design it has been possible to furnish proof of the influence of hand hygiene prior to insertion of peripheral venous catheters on the incidence of complications. In the first study detailed data were collected anonymously for each patient on the procedure used for catheter insertion or on any complications. Data were collected for around 64% of patients in one hospital. Evaluation of the questionnaires revealed that there was a significant increase in the incidence of complications in line with an increasing duration of the indwelling period of between 24 and 96 hours. The unexpected finding of this evaluation study was that in the case of catheters with an indwelling period of more than two days there were highly significantly lower complication rates in those cases in which hand disinfection was carried out or gloves donned before catheter placement. The second study, based on the former, documented the cases giving rise to complications. The proportion of peripheral venous catheters implicated in complications was 24%. Here, too, there was a sharp rise in the risk of complications in line with the duration of the indwelling period. Catheters placed in the OR during the patient's hospital stay showed a significantly lower risk of complications than those inserted on wards, or even in the outpatient department. Conductance of hygienic hand disinfection or the wearing of disposable gloves resulted in significantly lower complication rates compared to normal handwashing or omission of a hand hygiene measure. The most plausible explanation for this positive effect exerted by the wearing of disposable gloves or conductance of hygienic hand disinfection prior to catheter placement is that there was no recontamination during repalpation, as often seen, of the prepared venepuncture site.