Incidence of peripheral intravenous catheter: related phlebitis among hospitalized adults in Southwest Ethiopia—a prospective observational study

Abstract

Peripheral intravenous catheters (PIVCs) are among the most commonly used invasive devices in hospitalized patients. However, their use is frequently complicated by phlebitis, which contributes to patient discomfort, interruption of therapy, prolonged hospitalization, and increased healthcare costs. This study aimed to determine the incidence of PIVC-related phlebitis and identify associated factors among adult hospitalized patients at Jimma University Medical Center (JUMC), Southwest Ethiopia. A hospital-based prospective observational study was conducted among adult patients admitted to the emergency and medical wards of JUMC from 01 December 2025 to 07 March 2026. A total of 384 patients requiring PIVC were enrolled using a consecutive sampling technique, of which 372 completed inpatient follow-up. Data were collected through patient interviews, direct observation, and medical record review using a structured questionnaire. Phlebitis was assessed using Jackson’s Visual Infusion Phlebitis (VIP) scoring system. Data were entered into EpiData version 4.6 and analyzed using SPSS version 25. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with phlebitis. Statistical significance was declared at p < 0.05. The overall incidence of PIVC-related phlebitis was 55.9% (95% CI 50.8–60.9). Most cases were mild, with grade 1 and grade 2 phlebitis accounting for 47.2% and 36.2% of cases, respectively. Female sex (AOR = 4.6, 95% CI 2.68–8.06), longer catheter dwell time (per additional day) (AOR = 1.38, 95% CI 1.18–1.61, P = 0.01), administration of intravenous medications (AOR = 2.3, 95% CI 1.15–4.62), and catheter insertion in the emergency unit (AOR = 2.6, 95% CI 1.52–4.58) were independently associated with phlebitis. The incidence of PIVC-related phlebitis at JUMC was markedly higher than internationally recommended threshold. Increasing catheter dwell time, intravenous medication administration, emergency unit catheter insertion, and female sex were independently associated with phlebitis. Strengthening infection prevention practices, routine catheter site monitoring, timely catheter replacement, and adherence to evidence-based catheter management protocols are essential to reduce the burden of phlebitis and improve patient safety. Not applicable.