Buxton 1979.

Methods	Randomized controlled trial
Participants	600 patients who had new infusions begun within the previous 24 hours. Four general medical wards (each with an ICU) and 4 general surgical wards at a general hospital, USA
Interventions	Administration set changes at 24 or 48 hours
Outcomes	Infusate colonization All‐cause BSI
Notes	Exclusions: IV sets in for < 48 hours; heparin locks, PN, participants previously in study, cannulation < 2 weeks, protocol failure Central catheters: 0% PN: 0% Loss to follow‐up: 39%
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Adequate random sequence generation used Quote: "used a random number table to assign each new patient"
Allocation concealment (selection bias)	Unclear risk	Not discussed
Blinding (performance bias and detection bias) All outcomes	Unclear risk	Not discussed, not feasible because of research design
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Not discussed, not feasible because of research design
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Blinded outcome assessment (phlebitis) Quote: "a nurse or physician observer who had no knowledge of when each patient's AS was changed evaluated each patient daily for the presence of phlebitis" (p. 765) Not discussed whether IV fluid colonization outcome was assessed by blinded scientists No explanation about how BSIs were detected
Incomplete outcome data (attrition bias) All outcomes	High risk	Minimal attrition information provided Quote: "A total of 987 patients were initially entered into the study, but 387 patient infusions were stopped in < 48 h" (p. 765) Possible participants treated at 24 hours had bacteraemia less than 48 hours, so intention to treat principle not upheld
Selective reporting (reporting bias)	Low risk	No pre‐protocol All outcomes provided