Josephson 1985.

Methods	Randomized controlled trial
Participants	173 medical patients who had an IV started in the previous 24 hours. 350 bed university hospital, USA
Interventions	Administration set changes at 48 hours or no change for the remainder of the cannula placement (i.e. at least 72 hours)
Outcomes	Infusate colonization IR‐BSI
Notes	Exclusions: casein, fat emulsions or blood in lines or vascular line monitoring systems Central catheters: 0% PN: 0% Loss to follow‐up: not stated
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Adequate random sequence generation Quote: "were randomly assigned according to a table of random numbers" (abstract and p. 368)
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	Outcome blinding possible but not discussed
Incomplete outcome data (attrition bias) All outcomes	High risk	Imbalanced attrition Quote: "Patients whose IVs were in place for fewer than three days or whose tubing change protocol was broken prior to three days of therapy were dropped from the study". This occurred 166 times in the 48 hour group and 106 times in the no‐change group" (p. 368)
Selective reporting (reporting bias)	Unclear risk	No pre‐protocol Only 26% of tips were cultured (all were required, as it was a secondary endpoint)
Other bias	High risk	Multiple infusions per participant randomly assigned