Visual Infusion Phlebitis Scale Research Articles

Efficacy and safety of quick penetrating solution heparin, quick penetrating solution diclofenac, and heparin gel in the prevention of infusion-associated superficial thrombophlebitis: A randomized controlled trial

Abstract Background: The present study aimed to compare the efficacy, safety, and cost-effectiveness of quick penetrating solution (QPS) heparin, QPS diclofenac, and heparin gel in the prevention of superficial thrombophlebitis (ST). Materials and Methods: This randomized controlled trial was conducted after approval from the Institutional Ethics Committee and registration to Clinical Trial Registry of India. Patients of 18–60 years age, American Society of Anesthesiologists I/II, and who needed venous cannulation for at least 72 h were included in the study. Patients were randomly divided into three groups receiving study drugs (heparin gel, QPS heparin, and QPS diclofenac) every 8 hourly for a period of 72 h. Venous cannulation site was graded using the Visual Infusion Phlebitis Scale. Patients developing no ST, mean time to reach ST Grade 1 and 2, prevention of ST probability, and cost-effectiveness of interventions during the study period were assessed. Results: Out of 219 included patients, development of no ST in the study groups at 72 h of treatment were heparin gel (11%), QPS heparin (9.6%), and QPS diclofenac (2.7%). The mean time (hours) to develop any grade ST in the study arms was heparin gel (36.2 [11.9]), QPS heparin (40.0 [13.4]), and QPS diclofenac (37.0 [13.2]). The Kaplan–Meier analysis did not reveal significant differences for the prevention of any grade ST or severe ST in three treatment arms. The average cost-effectiveness ratio for preventing thrombophlebitis was 14.2 in heparin gel-, 13.2 in QPS heparin-, and 95.6 in QPS diclofenac-treated patients. Conclusion: Based on efficacy, safety, and cost-effectiveness, heparin gel or QPS heparin can be used to prevent ST due to intravenous cannulation in surgical patients. QPS diclofenac is not a cost-effective option to prevent ST.

Effects of open-label sesame oil applied to cardiac surgery patients in preventing amiodarone-induced phlebitis: A randomized controlled trial.

Amiodarone is a prophylactic rhythm-regulating drug used to prevent arrhythmia; However, especially during infusion, it has the potential to cause a number of complications, especially phlebitis. The aim of the study is to determine the effects of sesame oil, which has the potential to prevent phlebitis that may occur during amiodarone infusion administered to patients after cardiac surgery. This prospective, two-arm (1:1), block randomized controlled interventional study. This study was conducted with 44 patients treated in the coronary intensive care unit of a university hospital, who received parenteral infusion of amiodarone. Sesame oil was applied superficially by applying 10 drops to a 10 cm perimeter of the cannula for 10 min. This application was repeated every 8 h during the 24-h amiodarone infusion. No intervention was made to the patients in the control group. However, standard nursing care measures and a standard transparent dressing were applied to the patients in both groups during the peripheral catheter application phase. Patients in the intervention and control groups were evaluated in terms of phlebitis at the end of every 24 h using the Visual Infusion Phlebitis Scale. The study was reported according to the CONSORT declaration. Phlebitis symptoms occurred in 15/22 (68.2%) of the patients in the intervention group on the first day, 3/22 (13.6%) on the second day and 2/22 (9.1%) of the patients on the third day, while in the control group, 20/22 (90.9%) of the patients had phlebitis on the first day and 2/22 (9.1%) on the second day. The incidence of phlebitis was 20/22 (90.9%) in the intervention group and 22/22 (100%) in the control group. There was no statistically significant difference in phlebitis symptoms between groups. The research results showed that the application of sesame oil did not significantly reduce the frequency of phlebitis. However, a trend indicating delayed onset of phlebitis symptoms was observed in the sesame oil group. Nevertheless, larger sample studies are needed. These studies are expected to assist in determining the effects of sesame oil on phlebitis more precisely and provide stronger support for the results. Training of nurses on non-pharmacological methods should be supported and opportunities should be given for their application.

Peripheral intravenous catheter-associated phlebitis and drug administration: Retrospective incident analysis

Background: Phlebitis is a complication associated with peripheral intravenous catheters and an adverse event.Objective: To analyze peripheral intravenous catheter-associated phlebitis incidents associated and drug administration to adult inpatients and their consequences. Methodology: Quantitative, retrospective, descriptive, and cross-sectional study. Non-probabilistic convenience sampling technique was used, with 96 adult patients hospitalized in 2019 selected in the area of medicine at a Hospital Center in Lisbon. The type of phlebitis incident was characterized using the Visual Infusion Phlebitis scale adapted and translated to European Portuguese. Patient harm was categorized according to the International Classification for Patient Safety (ICPS). Results: Of the documented phlebitis incidents, 78% obtained a score 2 on the VIP PT-PT scale. According to the ICPS, 87.5% resulted in mild harm and 12.5% in moderate harm. Antibiotics were the most frequent therapeutic group. Conclusion: Phlebitis has an impact on patient safety. The importance of nursing care is reinforced, with a focus on surveillance and early detection of phlebitis to prevent complications.

PREVALENCE OF PHLEBITIS AMONG PATIENTS RECEIVING PERIPHERAL INTRAVENOUS THERAPY IN A TERTIARY CARE HOSPITAL IN INDIA

Background: Phlebitis is a common complication associated with the use of peripheral intravenous catheters. Main uses of a peripheral intravenous catheter are infusions, blood sampling, administration of parenteral medications and blood products. It is one of the commonly performed procedure in hospital. Almost all of hospital admissions lead to intravenous catheter placement. Aim:To assess the prevalence of phlebitis among patients on peripheral intravenous catheter and identify predisposing factors of phlebitis in patients. Methodology: 398adult patients in wards, with Peripheral intravenous catheter (PIVC) were included in the study during a period of 4 months. Catheter insertion site of these patients were observed for signs of phlebitis using Visual Infusion Phlebitis scale, until discharge or until the resite of next catheter. The data collection and analysis included patient demographic details and data related to catheter (including number of attempts during insertion, experience of staff performing the cannulation, reasons for removal etc.), as well as the data on the type of administered medications and intravenous therapy. Results:A total of 398 patients were enrolled, among which 228 were males and 170 were females. A total of 192 patients (48.24%) showed one or other early signs of phlebitis. Among these 192 patients with early signs of phlebitis, 128 patients (66.67%) had score 1 in VIP scale while 64 patients (20.47%) had score 2 and 3.Phlebitis was found to be associated with mobility status of the patients (<0.001). Conclusion:This study showed a high prevalence of phlebitis among inpatients in wards. However, most of these cases were mild Grade 1 phlebitis.Its crucial to train and upskill staffs on PIVC insertion and monitoring to ensure proper placement and assessment. Daily assessment of insertion site and need for PIVC and patient awareness on PIVC maintenance is crucial in prevention of phlebitis.

Changes in nurses’ knowledge and clinical practice in managing local IV complications following an education intervention

Abstract Background Peripheral venous catheters (PVCs) are the most common invasive route for the rapid administration of medication and fluids. The care of PVC sites after cannulation can pose challenges depending on nurses’ level of knowledge and practice. Aim To transfer nurses’ knowledge into practice on preventing common local complications of intravenous (IV) therapy. Design A quasi-experimental study was undertaken. Methods: A convenience sample of nurses from surgical and medical wards of a university hospital (n=64) was used. Pre- and post-education intervention levels of nurses’ knowledge, practice and maintenance of PVCs, and the use of a visual infusion phlebitis scale to identify potential complications were assessed. Results: The effectiveness of the course was statistically significant for all three parameters (P<0.001). Conclusion The study highlighted the importance of ongoing education based on the latest available evidence to enable nurses to improve their knowledge and clinical practice with regard to PVC care and associated complications.

Incidence and type of peripheral intravenous catheter complications documented in hospitalised dogs.

To report the incidence and type of peripheral intravenous catheter complications in hospitalised dogs. A prospective, observational trial was performed. Peripheral intravenous catheters were monitored for complications. Complications were documented and classified as extravasation, phlebitis, dislodgement, occlusion and line breakage. If phlebitis was present, the Visual Infusion Phlebitis Scale was used to assign a grade (0 to 5). Fisher's exact test was used to compare the type of complications between the critical care unit and the intermediate care unit. A univariate logistic model was used to compare the incidence of complications between the critical care unit and the intermediate care unit and adjusted odds ratios were used to compare the groups. The incidence of peripheral intravenous catheter complications was 24.2% in the Critical Care Unit and 13.1% in the Intermediate Care Unit, with an overall incidence of 19.9%. Phlebitis was the most common peripheral intravenous catheter complication in the Critical Care Unit, and line breakage was the most common complication in the Intermediate Care Unit. Length of hospitalisation and weight had a significant effect on the likelihood of complication. In a multivariable logistic regression model, the odds of a peripheral intravenous catheter complication was not significantly higher in CCU than IMCU, accounting for length of hospitalisation and weight (adjusted odds ratio, 1.84; 95% confidence interval, 0.98 to 3.48). Peripheral intravenous catheter complications are common in hospitalised dogs and may result in an increased expense for owners, failure to deliver prescribed treatments, venous depletion (lack of peripheral vessels for intravenous catheter placement) and pain experienced by the patient. Techniques to reduce peripheral intravenous catheter complications should be further evaluated and may include the use of peripheral intravenous catheter placement and maintenance checklists, use of force-activated separation devices, or patient sedation.

Evaluation of local inflammation associated with peripheral intravenouscatheter insertion in Quang Tri General Hospital

Introduction: Local inflammation associated with peripheral intravenous cannula insertion is an important issue in taking care of patients in Quang Tri General Hospital. Objectives: Determining the rate of local inflammation associated with using a peripheral intravenous catheter (PIC) and finding out the relevant factors of local inflammation caused by the peripheral intravenous catheter. Methodology: Cross-sectional survey was applied to 340 patients in Quang Tri General Hospital by using the questionnaire with the VIP scale (Visual Infusion Phlebitis Scale). Results: The incidence of local inflammation was 7.9% after using PIC, with local inflammation Grade. I was the highest proportion (70.4%). The relevant factors of local inflammation after using PIC include age (> 70), treatment in the intensive care unit, the number of catheter placements (> 3), time remaining in place (24 - 48 h), size 20 G, and group drug chemistry. Conclusion: The incidence of local inflammation was 7.9% after using PIC. Observe to detect local inflammation soon after using a peripheral intravenous catheter to improve the quality of patient care. Key words: local inflammation, peripheral intravenous catheter

A study to assess the effect of hot fomentation on thrombophlebitis among patients undergoing intravenous therapy admitted in the selected hospitals of Guwahati, Assam

Thrombophlebitis is contemplated as an adverse event resulting from iv therapy. Thrombophlebitis can occur due to mechanical, chemical and infective causes which lead to pain, inflammation, infiltration, injuring a nerve as well as extravasation, ecchymosis, hematoma, thrombosis and embolism are also common. To assess the effect of hot fomentation on thrombophlebitis among patients undergoing intravenous therapy.: For this study quantitative research approach was adapted and using true experimental pre-test - post-test control group design the study was conducted. Total sample 60 (30 for experimental and 30 samples for control group) were selected by simple random sampling technique was used and among patients with thrombophlebitis getting IV therapy in Medical Ward at GMCH, Assam. Modified visual infusion phlebitis scale was used to assess pre-test level of thrombophlebitis and post-test level of thrombophlebitis. Intervention was given over the site of thrombophlebitis and evaluated on the 4 day. : Findings showed that in experimental group mean pre-test thrombophlebitis score was 11.07±3.062 and in post-test mean thrombophlebitis score was 6.47±1.871 with mean difference was 4.60. In control group mean post-test thrombophlebitis score was 10.70±2.693 and in experimental group mean post-test thrombophlebitis score was 6.47±1.871 with mean difference was 4.23. The comparison was tested using unpaired t test with obtained (t=7.072) was statistically significant at p<0.05 level. Result revealed that hot fomentation was effective on level of thrombophlebitis among patients received intravenous therapy in experimental group as compared to control group. Hot fomentation is effective to reduce thrombophlebitis caused due to intravenous therapy.

Changes in nurses' knowledge and clinical practice in managing local IV complications following an education intervention.

Peripheral venous catheters (PVCs) are the most common invasive route for the rapid administration of medication and fluids. The care of PVC sites after cannulation can pose challenges depending on nurses' level of knowledge and practice. To transfer nurses' knowledge into practice on preventing common local complications of intravenous (IV) therapy. A quasi-experimental study was undertaken. A convenience sample of nurses from surgical and medical wards of a university hospital (n=64) was used. Pre- and post-education intervention levels of nurses' knowledge, practice and maintenance of PVCs, and the use of a visual infusion phlebitis scale to identify potential complications were assessed. The effectiveness of the course was statistically significant for all three parameters (P<0.001). The study highlighted the importance of ongoing education based on the latest available evidence to enable nurses to improve their knowledge and clinical practice with regard to PVC care and associated complications.

Chlorhexidine or povidone-iodine and alcohol: A pilot study for evaluating the incidence of phlebitis in neonates

BackgroundPhlebitis is a complication of peripheral venous catheter placement in neonates, and is a criterion for the quality of nursing care. It seems that choosing the right solution for disinfecting the catheter site can help reduce these complications. The present study aimed to compare chlorhexidine with Povidone-iodine alcohol on the incidence of phlebitis in preterm neonates. MethodsThis quasi-experimental study was conducted in the Neonatal Intensive Care Unit (NICU) in Alborz province- Iran in 2020. A total of 106 neonates, who met the inclusion criteria, were randomly assigned to group A (n = 53) and group B (n = 53). The Povidone-iodine-alcohol solution in group A and chlorhexidine gluconate solution in group B were used to disinfect the peripheral venous catheter site. The catheter placement site was monitored every 8 h and before each injection using the Visual Infusion Phlebitis Scale. ResultThe research results indicated that in participants, who used chlorhexidine after 48 h, the mean score of phlebitis was 0.14 ± 0.07, and in the group who used Alcohol-Povidone-iodine it was 0.68 ± 0.190. Also, there was a statistically significant difference between the two groups (p-value = 0.003). ConclusionChlorhexidine was more effective in reducing the incidence of phlebitis than Povidone-iodine and alcohol in neonates.

Hemşirelerin Flebite İlişkin Bilgi Düzeylerinin Periferik İntravenöz Kateter Değişimine Etkisinin İncelenmesi

Amaç: Çalışma, hemşirelerin flebite ilişkin bilgi düzeylerinin, periferik intravenöz kateter değişim kararını vermedeki etkisini belirlemek amacıyla tanımlayıcı ve kesitsel olarak uygulanmıştır. &#x0D; Materyal ve Metot: Araştırma, İstanbul’da bir üniversite hastanesinde Ağustos-Ekim 2019 tarihleri arasında gerçekleştirilmiştir. Araştırmanın örneklemini, dahili ve cerrahi kliniklerde çalışan ve araştırmaya katılmaya gönüllü olan 56 hemşire ve bu kliniklerde yatarak tedavi gören ve izlem kriterlerine uyan, periferik intravenöz kateter takılı olan 151 hasta oluşturmuştur. Veriler; Demografik Bilgi Formu, Periferal İntravenöz Kateter ve Flebit Bilgi Formu ve Periferik İntravenöz Kateter Gözlem Formu ve Görsel İnfüzyon Flebit Skalası ile toplanmıştır. Çalışmanın ilk aşamasında; hemşirelerin demografik özellikleri ile periferal intravenöz kateter uygulamaları ve flebite ilişkin bilgi düzeyleri belirlenmiştir. İkinci aşamada araştırmaya dahil olan hemşirelerin bakım verdikleri hastaların izlemi yapılmıştır. Dahiliye ve cerrahi kliniklerinde yatarak tedavi gören ve çalışma kriterlerine uyan hastalar 4 gün boyunca günlük olarak flebit yönünden araştırmacı tarafından gözlenmiştir. &#x0D; Bulgular: Çalışmada, hemşirelerin %55.4’ünün bilgi düzeyi yeterli bulunmuştur. Bilgi düzeyi yeterli bulunan hemşirelerin %45.2’si, bilgi düzeyi yetersiz olan hemşirelerin 32.0’ı Görsel İnfüzyon Flebit Skala puanına göre uygun kateter değişimi yaptığı belirlenmiştir. Flebite ilişkin bilgi düzeyi yeterli olan hemşireler ile bilgi düzeyi yeterli olmayan hemşirelerin doğru zamanda kateter değişimi yapmaları arasında istatistiksel olarak anlamlı bir fark bulunmamıştır (p=0.467). &#x0D; Sonuç: Sonuç olaraki hemşirelerin flebite ilişkin bilgi düzeylerinin kateter değişim kararını vermede etkili olmadığı belirlenmiştir. Hastanelerde, periferal kateter uygulama ve bakım rehberlerinin kanıta dayalı uygulama önerilerine göre güncellenmesi önerilmiştir.

MONITORING OF PERIPHERAL VENOUS CATHETERIZATION AT THE SURGICAL HOSPITAL

Introduction. Peripheral venous catheters are widely used in medical practice to provide continuous venous access for therapeutic and diagnostic purposes. Peripheral vascular catheterization can be accompanied by infectious complications, including catheter-related bloodstream infections. An effective system of epidemiological surveillance and infection control of catheter-related bloodstream infections has not been developed at the state level in Ukraine; there is no proper monitoring for administration site and no registration of complications associated with the vascular catheterization. The purpose of this work was to assess the validity and propriety of the use of peripheral venous catheters in patients who receive inpatient treatment. Materials and methods: Between October 2019 and April 2020, 93 adult patients who were peripheral venous catheterized in a surgical hospital in Kharkiv were included in a prospective epidemiological study. The author's observation card was used for data collection for each patient daily. The catheter site was observed daily, and the following symptoms were entered into the card: flushed skin, swelling, discharge, and pain at the administration site at rest and on palpation. Interpretation of symptoms was conducted using the visual infusion phlebitis scale by A. Jackson. Statistical processing of data was carried out using descriptive statistics methods. To identify the relationship between the nominative values, Pearson's criterion χ2 was determined with P &lt; 0.01. Research results: 51 women (54.8%) and 42 men (45.2%) aged 18 to 84 were enrolled. In total, patients spent 619 bed-days in the hospital, of which the proportion of days with vascular catheters equaled 90.8% (n = 562). The main indication for the catheterization procedure was multicomponent therapy or the use of incompatible medications (98.9% / n = 92). In total, 148 peripheral venous catheters were inserted in these patients. The number of vascular catheters per patient ranged 1 to 3. According to the data of daily monitoring of the administration site, the signs of inflammation were observed in 65.5% of cases (n = 97). The incidence of signs of inflammation at the administration site with the first catheterization was significantly higher (χ2 = 25.2804; p &lt; 0.00001) than that with the second or third catheterization. The signs of local inflammation, which were more common in patients with vascular catheters, included flushed skin in the area of the catheter site (65.5% / n = 97), complaints of pain on palpation in the area of the catheter site (60.8% / n = 90) and swelling in the area of the catheter site (57.4% / n = 85). It was found that for more than half of the cases (55.4% / n = 82), the patients had symptoms of middle-stage phlebitis. It was also revealed that the most common reason for the removal of a peripheral venous catheter (n = 148) in the studied hospital were signs of local inflammation at the catheter site (61.5% / n = 91). However, in 16.9% of cases (n = 25), the occurrence of at least two signs of local inflammation at the catheter site, which indicated the initial stage of phlebitis and required to rearrange the catheter, was not the reason for immediate catheter removal. Conclusions: Health care workers make mistakes when working with peripheral venous catheters; in particular, there is no timely replacement of vascular catheters in the event of signs of infusion phlebitis. To reduce the risk of infectious complications of vascular catheterization at a health facility, the indications for insertion and removal of peripheral venous catheters and central venous catheters should be clearly defined, and standard operating procedures for ensuring vascular access and algorithms for managing patients with vascular catheters should be developed and implemented. Keywords intravascular catheter, prospective epidemiological study, assessment of the catheter insertion site, infusion phlebitis, catheter-related bloodstream infections, infection control.

Effectiveness of an Intravenous Protection Device in Pediatric Patients on Catheter Dwell Time and Phlebitis Score

PurposeThe study aimed to examine the efficacy of the I.V. House UltraDressing for protecting peripheral intravenous catheters (PIVCs) in pediatric patients. MethodsThis randomized controlled trial comprised 60 pediatric patients (aged 2–24 months): 30 in the experimental group and 30 in the control group. The PIVC dwell time and phlebitis scores were also reported for both groups. The degree of phlebitis was determined using the Visual Infusion Phlebitis Scale (VIPS) and was recorded every 8 hours from the start of antibiotic therapy until catheter removal. ResultsThe mean catheter dwell time in the experimental group (2.10 ± 1.55 days) was significantly longer than that in the control group (1.27 ± 0.45 days) (p < .01). However, there were no significant differences between the scores and signs of phlebitis in both groups (p > .05). ConclusionThe I.V. House UltraDressing is a useful device that can be used to increase catheter dwell time and protect and stabilize PIVCs in pediatric patients.

A prospective randomized study to evaluate safety and efficacy of heparin topical solution (1000 IU/ml) compared to heparin topical gel (200 IU/g) in prevention of infusion-associated phlebitis.

OBJECTIVES:Thrombosis and thrombophlebitis of the superficial venous system are common in hospitalized patients. Efficacy and safety of topical quick penetrating solution (QPS) of heparin were compared to heparin sodium topical gel for the prevention of infusion-associated phlebitis.MATERIALS AND METHODS:Patients aged 18–65 years undergoing intravenous cannulation for at least 72 h were enrolled and randomized to receive 6–8 drops of topical solution of heparin (Group sodium topical solution [QPS]) or1 g of topical gel (Group GEL) over the cannulated vein every 8 hourly for a total of 10 doses. Enrolled patients were monitored every 8 ± 1 h for phlebitis using visual infusion phlebitis scale. The primary aim was to compare the proportion of patients with Grade 0, I, and II phlebitis at the end of 72 h of treatment period.RESULTS:Number of patients assessed for eligibility was 110; 26 excluded and 84 randomized. Analysis was done for 41 administered heparin QPS and 33 administered heparin gel as the rest were lost to follow-up. No phlebitis was reported in 32% of patients in QPS group and 9% in GEL group (P =0.0019). Proportion of patients with Grade I and Grade II phlebitis was 22.9% and 13.5% with QPS and 35.13% and 22.97% with gel, respectively, and the difference was statistically significant. Mean time to develop Grade I (Group QPS = 59.7 h; Group GEL = 58.46 h; P = 0.949) and Grade II (Group QPS = 62.4 h; Group GEL = 61.17 h; P = 0.732) phlebitis was comparable no adverse effects were reported in either group.CONCLUSION:Heparin QPS was more effective in he prevention of infusion-associated phlebitis with similar safety profile as heparin gel.

Incidence and risk factors of phlebitis associated to peripheral intravenous catheters

ObjectiveTo determine the incidence and risk factors of phlebitis associated to the care of peripheral vascular catheters (PVC). MethodProspective cohort study at the Central University Hospital of Asturias (Spain). A total of 178 PVC were observed daily until their extraction. The incidence of phlebitis was measured using the visual infusion phlebitis scale, that distinguishes between grade I (possible phlebitis) and II (phlebitis). The independent diagnoses of phlebitis made by staff nurses were also collected. Finally, data about the insertion and the care of the PVC was also obtained. The incidence of phlebitis and the validity of the diagnoses made by staff nurses were calculated and the risk factors of phlebitis were determined by means of logistic regression. Results5.6% of the PVC presented phlebitis, 21.3% possible phlebitis and 11.2% had phlebitis according to nurses’ criteria. The staff nurses had a sensitivity of 100%, a specificity of 94% and a positive predictive value of 50% in the diagnosis of phlebitis. After adjusting for potential confounders, the use of an extension tube as an accessory of the PVC was an independent predictor of phlebitis (odds ratio: 4.8; P=0.04), but a PVC size of 22/24 gauges was associated with lower phlebitis incidence (odds ratio: 0.2; P=0.02). ConclusionsClinical phlebitis assessment is difficult because the agreement for phlebitis diagnosis is low. To minimise the incidence of phlebitis would be recommended to choose the smallest PVC size possible and to avoid using an extension tube as an accessory of the PVC.

Incidence and risk factors of phlebitis associated to peripheral intravenous catheters.

To determine the incidence and risk factors of phlebitis associated to the care of peripheral vascular catheters (PVC). Prospective cohort study at the Central University Hospital of Asturias (Spain). A total of 178PVC were observed daily until their extraction. The incidence of phlebitis was measured using the Visual Infusion Phlebitis Scale, that distinguishes between gradei (possible phlebitis) andii (phlebitis). The independent diagnoses of phlebitis made by staff nurses were also collected. Finally, data about the insertion and the care of the PVC was also obtained. The incidence of phlebitis and the validity of the diagnoses made by staff nurses were calculated and the risk factors of phlebitis were determined by means of logistic regression. 5.6% of the PVC presented phlebitis, 21.3% possible phlebitis and 11.2% had phlebitis according to nurses' criteria. The staff nurses had a sensitivity of 100%, a specificity of 94% and a positive predictive value of 50% in the diagnosis of phlebitis. After adjusting for potential confounders, the use of an extension tube as an accessory of the PVC was an independent predictor of phlebitis (odds ratio: 4.8; P=.04), but a PVC size of 22/24 gauges was associated with lower phlebitis incidence (odds ratio: 0.2; P=.02). Clinical phlebitis assessment is difficult because the agreement for phlebitis diagnosis is low. To minimize the incidence of phlebitis would be recommended to choose the smallest PVC size possible and to avoid using an extension tube as an accessory of the PVC.

Prevalence of Phlebitis and Comparison of the Effectiveness of Topical Ichthammol Glycerin and Heparinoid Application on Phlebitis among Patients on Peripheral Intravenous Therapy

Aim: The aim of this study was to determine the prevalence of phlebitis and compare the effectiveness of topical ichthammol glycerin and heparinoid application on phlebitis among patients receiving intravenous therapy. Background: The incidence of thrombophlebitis varies and various treatment modalities are available for treating phlebitis. Design: Quasi experimental design. Method: The study was conducted in the general medical, surgical and orthopaedic wards among 90 patients. Cluster randomization technique was used to allocate the wards to each interventional group. Consecutive sampling technique was used to select the subjects from each ward. Subjects were observed for 48 hours with an interval of 12 hours. Visual infusion phlebitis scale and numeric pain intensity scale were used to collect data.

Nursing care as a predictor of phlebitis related to insertion of a peripheral venous cannula in emergency departments: findings from a prospective study

To date, few studies have investigated the occurrence of phlebitis related to insertion of a peripheral venous cannula (PVC) in an emergency department (ED). To describe the natural history of ED-inserted PVC site use; the occurrence and severity of PVC-related phlebitis; and associations with patient, PVC and nursing care factors. A prospective study was undertaken of 1262 patients treated as urgent cases in EDs who remained in a medical unit for at least 24h. The first PVC inserted was observed daily until its removal; phlebitis was measured using the Visual Infusion Phlebitis Scale. Data on patient, PVC, nursing care and organizational variables were collected, and a time-to-event analysis was performed. The prevalence of PVC-related phlebitis was 31%. The cumulative incidence (78/391) was almost 20% three days after insertion, and reached >50% (231/391) five days after insertion. Being in a specialized hospital [hazard ratio (HR) 0.583, 95% confidence interval (CI) 0.366-0.928] and receiving more nursing care (HR 0.988, 95% CI 0.983-0.993) were protective against PVC-related phlebitis at all time points. Missed nursing care increased the incidence of PVC-related phlebitis by approximately 4% (HR 1.038, 95% CI 1.001-1.077). Missed nursing care and expertise of the nurses caring for the patient after PVC insertion affected the incidence of phlebitis; receiving more nursing care and being in a specialized hospital were associated with lower risk of PVC-related phlebitis. These are modifiable risk factors of phlebitis, suggesting areas for intervention at both hospital and unit level.

The effect of saline lock on phlebitis rates of patients in cardiac care units.

Background:Despite advances in the field of intravenous therapy, phlebitis is still a common complication of peripheral venous catheter and finding an appropriate solution to prevent and reduce the incidence of this complication remains challenging. One of the methods used in reducing the incidence of phlebitis is the use of saline lock, which is forgotten in most hospitals. Therefore, this study aimed to evaluate its impact on the incidence and severity of phlebitis.Materials and Methods:In a single-blind (the researcher) clinical trial, 88 patients with peripheral venous catheter admitted in cardiac care units in selected hospitals of Isfahan University of Medical Sciences, Iran, were selected through convenient sampling method. They were randomly divided into two groups of intervention and control groups using random number table. The intervention group received 3 ml of 0.9% normal saline sterilized before and after each intravenous drug or every 12 h. However, in the control group, the intravenous drugs were given as routine and saline lock was not used. The evaluation of intravenous catheter regarding the incidence of phlebitis and its degrees using Jackson's Visual Infusion Phlebitis Scale was performed 6 times within 72 h (every 12 h). Results were evaluated by SPSS software using descriptive statistics, Chi-square test, t-test, and Mann–Whitney test.Results:Results showed that there was a statistically significant difference between the two groups regarding the degree of phlebitis (P = 0.003). The percentage of phlebitis incidence in the control group was 88.6% and in the intervention group was 43.2%. There was a statistically significant difference between the two groups (P < 0.001). The risk of incidence of phlebitis in the group without saline lock (control), compared to the intervention group, was 10.3 times greater (CI = 95%). The incidence of phlebitis in both groups increased with increase in the duration of catheter placement.Conclusions:The results of this study showed that the use of saline lock in the intervention group compared to the control group, in which saline lock was not used, can have a significant impact on reducing the incidence of phlebitis and its degree.

A Quasi Experimental Study to Assess the Effect of Hot Application on Phlebitis among Patients on Intravenous Therapy at Selected Hospitals, Jalandhar, Punjab, 2014

Intravenous therapy is a routine nursing task in any hospital. It has become a major component of patient care. However, the placement of an intravenous cannula can have undesirable effects, the most common of which is phlebitis. Nurses should be aware of the appropriate interventions to facilitate comfort for the patients on intravenous therapy and take measures to reduce such complications. In this study, Quasi experimental (Non equivalent pre test post test control group) research design was used and 80 patients with phlebitis were taken by using purposive sampling technique. 40 patients were included in experimental group & 40 in control group. Ethical considerations were followed during the research study. Pre test was done by assessing the grade of phlebitis with Visual infusion phlebitis scale in both groups on 1st day and hot application was provided for 15 minutes twice a day for 3 days in the experimental group. After that post test was done in both groups on 3rd day. The result showed that the mean pre test grade of phlebitis in experimental & control group were 2.02 ±0.61and 1.32 ± 0.47 respectively. The mean post test grade of phlebitis in experimental & control group were 0.95 ± 0.59 and 1.5 ± 0.71 respectively. In experimental group, there was significant (tcal7.9015 at p<0.05) difference between mean pre test and mean post test grade of phlebitis as compared to control group. Hence, it is concluded that hot application had significant effect on phlebitis among patients on intravenous therapy.