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Trial registered on ANZCTR
Registration number
ACTRN12615000408583
Ethics application status
Approved
Date submitted
30/03/2015
Date registered
30/04/2015
Date last updated
22/12/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Flushing in Peripheral intravenous catheters (FliP): A pilot factorial, randomized trial of high versus low frequency and volume in paediatrics. (‘FliP in Kids’).
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Scientific title
To assess the effectiveness of high frequency flushing and volume versus low frequency flushing and volume on device failure in paediatric patients with a peripheral venous catheter. (‘FliP in Kids’).
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Secondary ID [1]
286445
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Nil
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Universal Trial Number (UTN)
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Trial acronym
FliP in Kids
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Peripheral cannula maintenance
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Condition category
Condition code
Public Health
294919
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0
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Health service research
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Infection
294920
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0
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Studies of infection and infectious agents
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants will have their peripheral cannula (PIVC) flushed with one of the following, until the patient requires PIVC removal, by the nurse providing care for the patient:
1. low frequency IV flush 0.9% Sodium Chloride every 24h, low volume 3mL
2. low frequency IV flush 0.9% Sodium Chloride every 24h , high volume 10mL
3. high frequency IV flush 0.9% Sodium Chloride every 6h, low volume 3mL
4. high frequency IV flush 0.9% Sodium Chloride every 6h, high volume 10mL
AND
pre and post medication administration.
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Intervention code [1]
291522
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Prevention
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Intervention code [2]
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Treatment: Devices
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Comparator / control treatment
The high frequency arm. Standard frequency of PIVC flushes (and therefore control/comparator) was Q6h (i.e. 4 times a day). Volume varied.
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Control group
Active
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Outcomes
Primary outcome [1]
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Feasibility of definitive factorial RCT: composite analysis of feasibility criteria:
Eligibility: greater than or equal to 70% of patients screened will be eligible
Recruitment: greater than or equal to 80% of patients eligible agree to enroll
Retention: less than or equal to 10% of patients are lost to follow up or withdraw
Protocol adherence: greater than or equal to 90% of patients receive their allocated treatment
Missing data: less than or equal to 10% data are missed
Sample size estimates: Estimates of proportion of PIVC device failure associated with each treatment.
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Assessment method [1]
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Timepoint [1]
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12 months post study commencement
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Secondary outcome [1]
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PIVC failure defined by a composite analysis of occlusion, infiltration, dislodgment or phlebitis defined as follows and in keeping with normal clinical assessment: occlusion (thrombotic or non-thrombotic, partial or complete); infiltration (leaking of fluid/infusate in to surrounding tissue); dislodgment (partial or total from insertion site); phlebitits (pain or tenderness on scale of 0 no pain – 10 acute, and/or erythema or swelling at the site measured in centimentres, and/or palpable cord or vein streak yes.mo, <7,5cm, >7.5cm).
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Assessment method [1]
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Timepoint [1]
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While PIVC insitu or within 48 hours of PIVC removal
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Secondary outcome [2]
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Individual reasons for failure in keeping with normal clinical assessment documented in notes and further collected on trial daily check form: occlusion (thrombotic or non-thrombotic, partial or complete); infiltration (leaking of fluid/infusate in to surrounding tissue); dislodgment (partial or total from insertion site); phlebitits (pain or tenderness on scale of 0 no pain – 10 acute, and/or erythema or swelling at the site measured in centimentres, and/or palpable cord or vein streak yes.mo, <7,5cm, >7.5cm).
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Assessment method [2]
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Timepoint [2]
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Following removal of PIVC
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Secondary outcome [3]
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Phlebitis
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Assessment method [3]
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Timepoint [3]
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Phlebitis scores will be collected daily while PIVC is insitu and on removal of PIVC.
Phlebitis indicators will be measured as follows:
Pain from site: (no pain) 0…..1…..2…..3…..4…..5…..6…..7…..8…..9…..10 (acute pain)
Tenderness: (no tenderness) 0…..1…..2…..3…..4…..5…..6…..7…..8…..9…..10 (acute tenderness)
Erythema: should be measured from entry point with a ruler and scored:
None, <1cm, >1cm but <2.5cm, >2.5cm but <5cm, >5cm
Swelling: should be measured from entry point with a ruler and scored:
None , <1cm, >1cm but <2.5cm, >2.5cm but <5cm, >5cm
Palpable Cord or Vein Streak: Yes/No
Less than 7.5cm, greater than 7.5cm
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Secondary outcome [4]
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Dislodgement
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Assessment method [4]
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Timepoint [4]
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Data will be collected at the daily check when PIVC has been documented as dislodged
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Secondary outcome [5]
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Cost
Cost will be calculated based on the days each PIVC was insitu (per 1000 catheter days)
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Assessment method [5]
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Timepoint [5]
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Cost will be calculated at the completion of the trial
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Secondary outcome [6]
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Mortality
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Assessment method [6]
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Timepoint [6]
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Rate of mortality will be assessed on completion of the trial
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Secondary outcome [7]
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Laboratory confirmed bloodstream infection, Electronic pathology results will be checked up to 48 hours after PIVC removal.
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Assessment method [7]
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Timepoint [7]
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During PIVC dwell time and within 48 hours of removal
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Secondary outcome [8]
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PIVC dwell time in days and hours calculated from time and day of insertion and time and day of elective removal or failure and subsequent removal
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Assessment method [8]
341568
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Timepoint [8]
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at time of removal
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Eligibility
Key inclusion criteria
Peripheral intravenous catheter inserted for clinical care
Informed consent to participate
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Minimum age
No limit
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Maximum age
18
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients < 5kg or on fluid restrictions
Planned removal of Peripheral intravenous catheter within next 24hrs
Previous enrolment in the current study
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Computer generated allocation. Allocation is concealed until participant is randomised via a computerised randomisation service once consent has been given.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer generated
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Factorial
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
18/05/2015
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Actual
18/05/2015
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Date of last participant enrolment
Anticipated
2/10/2015
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Actual
23/11/2015
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Date of last data collection
Anticipated
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Actual
26/11/2015
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Sample size
Target
80
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Accrual to date
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Final
55
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
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Lady Cilento Children's Hospital - South Brisbane
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Recruitment postcode(s) [1]
9402
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4101 - South Brisbane
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Griffith University
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Address [1]
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Nathan Campus
170 Kessels Road
Nathan
Queensland, 4111
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Country [1]
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Australia
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Primary sponsor type
University
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Name
Griffith University
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Address
Nathan Campus
170 Kessels Road
Nathan
Queensland, 4111
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
289689
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Children's Health Queensland
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Ethics committee address [1]
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501 Stanley Street, South Brisbane, Qld 4101
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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19/08/2014
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Ethics approval number [1]
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HREC/14/QRCH/233
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Summary
Brief summary
Venous cannulation via peripheral intravenous catheters (PIVC) is the simplest and most frequently used method for drug, fluid and blood product administration. Researchers estimate that up to 70% of patients in acute care hospitals require a PIVC. However, PIVC are associated with inherent complications which can be mechanical or infectious. Failure rates of these devices is unacceptably high, affecting up to 40% of patients receiving this therapy. Of these, 30% failed due to occlusion and infiltration (fluids into surrounding tissues) meaning patients had to have the PIVC replaced, which has implications for patient comfort, therapy and health care costs.There have been a range of strategies developed to prevent or reduce PIVC related complications including flushing regimes to maintain PIVC patency. However, current flushing practice is widely varied, with poor outcomes. There is little evidence that flushing of PIVC is actually happening in practice. To achieve best and evidence based practice it imperative that trial research is conducted to establish the best regime for maintaining PIVC patency. The study aims to establish the feasibility of conducting a four arm, factorial, randomized trial evaluating the efficacy and cost effectiveness of different flushing frequencies and volumes in a paediatric population.
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Trial website
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Trial related presentations / publications
None to date (manuscript in progress)
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Public notes
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Contacts
Principal investigator
Name
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Prof Samantha Keogh
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Address
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Queensland University of Technology, School of Nursing, N Block, Victoria Park Road, Kelvin Grove, Brisbane Qld 4059
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Country
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Australia
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Phone
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+61 7 31383881
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Julie Flynn
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Address
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Centre for Clinical Nursing Level 2, Building 34 RBWH Butterfield Street Herston Queensland 4029
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Country
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Australia
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Phone
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+61 7 36468293
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Samantha Keogh
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Address
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Queensland University of Technology, School of Nursing, N Block Victoria Park Road, Kelvin Grove, Brisbane Qld 4059
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Country
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Australia
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Phone
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+61 731383881
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Flushing of peripheral intravenous catheters: A pilot, factorial, randomised controlled trial of high versus low frequency and volume in paediatrics.
2020
https://dx.doi.org/10.1111/jpc.14482
N.B. These documents automatically identified may not have been verified by the study sponsor.
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