A Study to Assess the Effectiveness of Proximal Massage and Hot Application on Risk of Thrombophlebitis Among IV Cannulated Patients Admitted in Selected Hospitals of Punjab

Abstract

Background: Thrombophlebitis is the most frequently reported complication of peripheral intravenous (IV) cannulation, with reported incidence ranging from roughly 4% to 67% depending on the clinical setting, and it is a leading reason for unplanned catheter removal. Simple, low-cost bedside measures that nurses can apply at the point of care are needed to limit this complication and the discomfort, cannula reinsertions, and added treatment costs that come with it.
Objective: To evaluate and compare the effectiveness of proximal massage and hot application in reducing the risk of thrombophlebitis among IV cannulated patients, and to examine whether post-intervention risk scores were associated with selected socio-demographic and clinical variables.
Methods: A quasi-experimental, time-series design was used at two tertiary care hospitals in Punjab, India. Using purposive sampling, 108 adult IV cannulated patients were allocated to Experimental Group I (proximal massage, n = 36), Experimental Group II (hot application, n = 36), or a Comparison Group (routine care, n = 36). Thrombophlebitis risk was rated at two pre-test and two post-test points with the Visual Infusion Phlebitis (VIP) scale. Because Kolmogorov–Smirnov testing indicated non-normal distribution, within-group change was analysed with the Wilcoxon signed-rank test and between-group comparison with the Kruskal–Walli’s test; associations with socio-demographic and clinical variables were examined using the Mann-Whitney U and Kruskal-Wallis tests.
Results: The three groups were statistically comparable at baseline (median VIP score = 0 in all groups; p = 1.000). By the second post-test, the Comparison Group's median VIP score had risen to 1 (mean rank 14.00; p < 0.001), while both Experimental Group I and Experimental Group II retained a median score of 0 with a smaller, though statistically detectable, upward shift confined to a minority of participants (mean rank 3.50; p = 0.014). Between-group comparison at the final post-test confirmed significantly lower risk scores in both intervention groups relative to the Comparison Group (p < 0.01). No socio-demographic or clinical variable (age, sex, BMI, smoking or alcohol history, cannula size or site, drug administration method, or comorbidity) was significantly associated with post-test VIP scores in any group.
Conclusion: Both proximal massage and hot application were associated with a markedly lower rise in thrombophlebitis risk than routine care alone over the four-day observation window, supporting their use as simple, non-pharmacological, nurse-administered adjuncts for patients with peripheral IV cannulas.