{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T02:05:33Z","timestamp":1784167533641,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T00:00:00Z","timestamp":1766880000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,12,28]],"date-time":"2025-12-28T00:00:00Z","timestamp":1766880000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,1]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Venous catheter selection is a crucial aspect of patient care, impacting treatment outcomes, patient safety and healthcare sustainability performance. While central venous catheters (CVCs) offer advantages for certain clinical situations, their safety profile compared to peripheral venous catheters (PVCs) remains a subject of debate.<\/jats:p>\n <\/jats:sec>\n \n Aim<\/jats:title>\n This study aimed to compare the safety profiles of CVCs and PVCs to inform evidence\u2010based practice and improve sustainability performance in venous catheter selection.<\/jats:p>\n <\/jats:sec>\n \n Study Design<\/jats:title>\n A two\u2010group, prospective observational cohort study included adult patients (\u2265\u200918\u2009years) admitted to the emergency department and intensive care units of a university hospital in Assiut, Egypt. The safety profile was assessed using three key metrics: the Infection Probability Score (IPS), rates of Healthcare\u2010Associated Infections and Sepsis (HAIS) and in\u2010hospital mortality.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n While all 200 enrolled patients completed the study (160 ICU, 40 ED), the subgroup analysis was limited to 160 ICU patients due to the smaller ED group size. Central venous catheters were associated with a higher rate of catheter occlusion (40.0% (\n n<\/jats:italic>\n =32) vs. 31.3% (\n n<\/jats:italic>\n =25),\n p<\/jats:italic>\n =0.248), while peripheral venous catheters were predominantly associated with phlebitis (18.8% (\n n<\/jats:italic>\n =15) vs. 27.5% (\n n<\/jats:italic>\n =22),\n p<\/jats:italic>\n =0.189) and extravasation (0.0% (\n n<\/jats:italic>\n =0) vs. 3.8% (\n n<\/jats:italic>\n =3),\n p<\/jats:italic>\n =0.080, OR = 7.2, 95% CI 2.7\u2013140.2). Furthermore, patients with central venous catheters had a higher mean infection prevention score (17.6 \u00b1 2.4 vs. 12.7 \u00b1 5.1,\n p<\/jats:italic>\n < 0.001,\n r<\/jats:italic>\n = 0.520) and a significantly greater likelihood of healthcare\u2010associated infections (91.3% (\n n<\/jats:italic>\n =73) vs. 25.0% (\n n<\/jats:italic>\n =29),\n p<\/jats:italic>\n < 0.001, OR = 31.3, 95% CI 12.4\u201379.0). Notably, mortality was significantly higher among patients with central venous catheters (71.3% (\n n<\/jats:italic>\n =57) vs. 6.3% (\n n<\/jats:italic>\n =5),\n p<\/jats:italic>\n < 0.001, OR = 37.2, 95% CI 13.3\u2013103.8).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n These findings suggest that, despite the potential benefits of central venous catheters, the presence of a CVC is associated with a higher risk of severe complications, including infection, healthcare\u2010associated infections, and mortality, compared to peripheral venous catheters in this observational cohort. This elevated risk profile may negatively impact sustainability performance by increasing resource utilization, treatment costs, and the burden of harm. The large observed effect sizes, supported by high post\u2010hoc power, strengthen the evidence for this association within the study population. However, as this was an observational study without adjustment for potential confounding factors such as severity of illness or indication for catheter type, these results demonstrate association and cannot infer causation. The findings highlight the complex risk\u2010benefit assessment required in clinical decision\u2010making.<\/jats:p>\n <\/jats:sec>\n \n Relevance to Clinical Practice<\/jats:title>\n These findings highlight the importance of a meticulous assessment of patient needs and risk factors when selecting a venous catheter. Clinicians should carefully weigh the potential benefits of central venous catheters against the increased risk of complications, particularly in patients with heightened susceptibility to infection or those requiring shorter\u2010term intravenous access. Prioritising peripheral venous catheters whenever feasible may contribute to improved patient safety, outcomes and overall sustainability performance of healthcare delivery by preventing costly complications and enhancing resource efficiency.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/nicc.70245","type":"journal-article","created":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T03:34:39Z","timestamp":1766979279000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Towards Evidence\u2010Based Practice: A Comparative Safety Analysis of Venous Catheters in Critically Ill Adults"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2526-9789","authenticated-orcid":false,"given":"Ghada Shalaby Khalaf","family":"Mahran","sequence":"first","affiliation":[{"name":"Department of Critical Care and Emergency, Faculty of Nursing Al\u2010Ahliyya Amman University Amman Jordan"},{"name":"Faculty of Nursing Assiut University Assiut Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muamar","family":"Aldalaeen","sequence":"additional","affiliation":[{"name":"Faculty of Nursing Philadelphia University Amman Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdy","family":"Mahdy","sequence":"additional","affiliation":[{"name":"Anesthesiology Department, Faculty of Medicine Assiut University Assiut Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bedour Adel","family":"Mohamed Ibrahim","sequence":"additional","affiliation":[{"name":"Medical Surgical Nursing, Faculty of Nursing Minia University Minia Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola Ebrahim","family":"Elsherbiny","sequence":"additional","affiliation":[{"name":"Medical Surgical Nursing Department, Faculty of Nursing Mansoura University Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mostafa Muhammad Ahmed","family":"Ali","sequence":"additional","affiliation":[{"name":"Critical Care and Emergency Nursing, Faculty of Nursing Assiut University Assiut Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8874-6936","authenticated-orcid":false,"given":"Wafaa Wahdan Abd","family":"El\u2010aziz","sequence":"additional","affiliation":[{"name":"Medical\u2010Surgical Nursing Department, Faculty of Nursing Al\u2010Baha University Al\u2010Baha Saudi Arabia"},{"name":"Critical Care and Emergency Nursing, Faculty of Nursing Mansoura University Mansoura Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,28]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/nop2.2252"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jep.14308"},{"key":"e_1_2_15_4_1","volume-title":"Quality Health Services","author":"World Health Organization","year":"2020"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/NAN.0b013e31825af099"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.55716"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/NAN.0b013e31824237ce"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.34172\/jcs.2021.012"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010020\u201058465\u20107"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/11297298221145035"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjoq\u20102020\u2010001218"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61082-4"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.7326\/M15-0744"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s43018-023-00657-1"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054\u2010018\u20102147\u20104"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1980\u2010220X2021039804842"},{"key":"e_1_2_15_17_1","doi-asserted-by":"publisher","DOI":"10.1142\/S2424835523500273"},{"key":"e_1_2_15_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/11297298231169059"},{"key":"e_1_2_15_19_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.917572"},{"key":"e_1_2_15_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028\u2010019\u201000843\u2010z"},{"key":"e_1_2_15_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_2_15_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-66951-9"},{"key":"e_1_2_15_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0163-4453(03)00100-2"},{"key":"e_1_2_15_24_1","doi-asserted-by":"publisher","DOI":"10.4236\/crcm.2020.98024"},{"key":"e_1_2_15_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD004219.pub4"},{"key":"e_1_2_15_26_1","doi-asserted-by":"publisher","DOI":"10.1080\/jmf.13.3.171.174"},{"issue":"2","key":"e_1_2_15_27_1","first-page":"100","article-title":"Evaluation of Peripherally Inserted Central Catheters in High\u2010Risk Newborns","volume":"11","author":"Xia B.","year":"2009","journal-title":"Chinese Journal of Contemporary Pediatrics"},{"key":"e_1_2_15_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7200182"},{"key":"e_1_2_15_29_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7211650"},{"key":"e_1_2_15_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6909.2007.00171.x"},{"key":"e_1_2_15_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40121\u2010019\u20100245\u20106"}],"container-title":["Nursing in Critical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nicc.70245","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nicc.70245","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nicc.70245","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T01:47:56Z","timestamp":1784166476000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nicc.70245"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,28]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/nicc.70245"],"URL":"https:\/\/doi.org\/10.1111\/nicc.70245","archive":["Portico"],"relation":{},"ISSN":["1362-1017","1478-5153"],"issn-type":[{"value":"1362-1017","type":"print"},{"value":"1478-5153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,28]]},"assertion":[{"value":"2025-02-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70245"}}