{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:08:54Z","timestamp":1790622534199,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,11,13]],"date-time":"2022-11-13T00:00:00Z","timestamp":1668297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["shmpublications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Medicine"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>One\u2010third of peripheral intravenous catheters (PIVCs) fail from inflammatory or infectious complications, causing substantial treatment interruption and replacement procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We aimed to compare complications between integrated PIVCs (inbuilt extension sets, wings, and flattened bases) and traditional nonintegrated PIVCs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Designs, Settings and Participants<\/jats:title><jats:p>A centrally randomized, controlled, superiority trial (with allocation concealment until study entry) was conducted in three Australian hospitals. Medical\u2013surgical patients (one PIVC each) requiring intravenous therapy for &gt;24\u2009h\u00a0were studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main Outcome Measures<\/jats:title><jats:p>The primary outcome was device failure (composite: occlusion, infiltration, phlebitis, dislodgement, local, or bloodstream infection). Infection endpoints were assessor\u2010masked. The secondary outcomes were: failure type, first\u2010time insertion success, tip colonization, insertion pain, dwell time, mortality, costs, health\u2010related quality of life, clinician, and patient satisfaction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Out of 1759 patients randomized (integrated PIVC,\u00a0<jats:italic>n<\/jats:italic>\u2009=\u2009881; nonintegrated PIVC,\u00a0<jats:italic>n<\/jats:italic>\u2009=\u2009878), 1710 (97%) received a PIVC and were in the modified intention\u2010to\u2010treat analysis (2269 PIVC\u2010days integrated; 2073 PIVC\u2010days nonintegrated). Device failure incidence was 35% (145 per 1000 device\u2010days) nonintegrated, and 33% (124 per 1000 device\u2010days) integrated PIVCs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>Integrated PIVCs had a significantly lower failure risk (adjusted [sex, infection, setting, site, gauge] hazard ratio [HR]: 0.82\u00a0[95% confidence interval, CI: 0.69\u20130.96], <jats:italic>p<\/jats:italic>\u2009=\u2009.015). The per\u2010protocol analysis was consistent (adjusted HR: 0.80 [95% CI: 0.68\u20130.95], <jats:italic>p<\/jats:italic>\u2009=\u2009.010). Integrated PIVCs had significantly longer dwell\u00a0(top quartile\u2009\u2265\u200995\u00a0vs. \u226584\u2009h). Mean per\u2010patient costs were not statistically different.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>PIVC failure is common and complex. Significant risk factors include sex, infection at baseline, care setting, insertion site, catheter gauge, and catheter type. Integrated PIVCs can significantly reduce the burden of PIVC failure on patients and the health system.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhm.12995","type":"journal-article","created":{"date-parts":[[2022,11,14]],"date-time":"2022-11-14T01:19:34Z","timestamp":1668388774000},"page":"21-32","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Integrated versus nonintegrated peripheral intravenous catheter in hospitalized adults (OPTIMUM): A randomized controlled trial"],"prefix":"10.1002","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6341-7415","authenticated-orcid":false,"given":"Claire M.","family":"Rickard","sequence":"first","affiliation":[{"name":"School of Nursing, Midwifery and Social Work The University of Queensland Centre for Clinical Research Herston Queensland Australia"},{"name":"Nursing and Midwifery Research Centre, Herston Infectious Diseases Institute, Metro North Health Royal 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