Determination of Phlebitis Rate with Visual Infusion Phlebitis Diagnostic Scale; An Observational Study

Abstract

Phlebitis is the inflammation of the tunica intima layer of the vein and is a common preventable complication of peripheral intravenous catheters (PIC). The aim of this study was to determine the rate of phlebitis development in patients with PIC implantation using the Visual Infusion Phlebitis Diagnostic Scale and to determine the associated factors. The study was conducted in the internal and surgical clinics of a public hospital between September 1, 2022 and February 1, 2023. The 'Patient Information Form', 'Peripheral Intravenous Catheter Evaluation Form' and 'Visual Infusion Phlebitis Diagnosis Scale' were used to collect the study data. In 30.3% of the patients with PIC, phlebitis developed and 48.9% of the phlebitis cases were grade 1. the variables such as sex and presence of a chronic disease did not affect the development of phlebitis. Phlebitis development was more common in patients in the 40-64 age group, on the wrist, on the left arm and on the actively used arm, in sites where the PIC was inserted in two or more attempts, in patients in whom 16 Fr or 18 Fr catheters were inserted, and in patients taking antibiotics.

Keywords

• Phlebitis
• Intravenous catheter
• Phlebitis Diagnostic Scale

Görsel İnfüzyon Flebit Tanılama Skalası ile Flebit Oranının Belirlenmesi; Gözlemsel Bir Çalışma

Abstract

Flebit; venin tunika intima tabakasının inflamasyonudur ve yaygın görülen önlenebilir bir periferik intavenöz katater (PİK) komplikasyonudur. Çalışmada PİK takılı olan hastalarda flebit gelişme oranlarının ile belirlenmesi ve ilişkili faktörlerin ortaya konması amaçlanmıştır. Çalışma, 1 Eylül 2022-1 Şubat 2023 tarihleri arasında bir devlet hastanesinin dahili ve cerrahi kliniklerinde yürütülmüştür. Veriler ‘Hasta bilgi formu’, ‘Periferik İntravenöz Kateter Değerlendirme Formu’ ve ‘Görsel İnfizyon Flebit Tanılama Skalası’ ile toplanmıştır. Hastalara uygulanan 122 PİK girişiminin %30.3’ünde flebit geliştiği ve gelişen flebitlerin % 48,9’unun 1. Derece flebit olduğu belirlenmiştir. Cinsiyet ve kronik hastalık varlığının flebit oluşumunu etkilemediği, 40-64 yaş grubunda, el bileğinde, sol tarafta ve aktif olarak kullanılan tarafta, ikinci veya tekrarlı denemelerde, 16 ve 18 numara kateterle takılan PİK’lerde ve antibiyotik kullanan hastalarda flebit oluşumunun arttığı belirlenmiştir.

Keywords

• Flebit
• İntravenöz katater
• Flebit Tanılama Skalası

References

1. Atay, S., Sen, S., Cukurlu, D., 2018. Phlebitis related peripheral venous catheterization and the associated risk factors. Nigerian Journal of Clinical Practice 21(7), 827–831.
2. Aydın, S., Arslan, G.G., 2018. Hemşirelerin periferal intravenöz kateter girişimlerine ilişkin bilgi düzeylerinin incelenmesi. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi 11(4),290-299.
3. Berse, S., Tosun, B., Tosun, N., 2020. Periferik intravenöz katetere bağlı flebit oranının ve etkileyen faktörlerin değerlendirilmesi. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi 13(3), 160-169.
4. Braga, L., Parreira, P., Oliveira, A. S. S., ónico, L. D. S., Arreguy-Sena, C., Henriques, M. A., 2018. Phlebitis and infiltration: Vascular trauma associated with the peripheral venous catheter. Latino-Americana de Enfermagem 26(2), 1–8.
5. Buzatto, L. L., Massa, G. P., Peterlini, M. A. S., Whitaker, I. Y., 2016. Factors associated with phlebitis in elderly patients with amiodarone intravenous infusion. Acta Paulista de Enfermagem 29(3), 260-266.
6. Chopra, V., Ratz, D., Kuhn, L., Lopus, T., Lee, A., Krein, S., 2014. Peripherally inserted central catheter-related deep vein thrombosis: contemporary patterns and predictors. Journal of Thrombosis and Haemostasis 12, 847-54.
7. Cicolini, G., Simonetti Comparcini, D., Labeau, S., Blot, S., Pelusi, G., Di Giovanni, P., 2014. Nurses’ Knowledge of evidence-based guidelines on the prevention of peripheral venous catheter-related ınfections: A multicentre survey. Journal of Clinical Nursing 23(17–18), 2578–2588
8. Cohen, L, Manion, L, Morrison, K., 2007. The ethics of educational and social research. In: Research Methods in Education. (Cohen L. eds.) NewYork NY: Routledge,20-50.

9. Couzigou, C., Lamory, J., Salmon-Ceron, D., Figard, J., Vidal-Trecan, G. M., 2005. Short peripheral venous catheters: Effect of evidence-based guidelines on insertion, maintenance and out comes in a university hospital. Journal of Hospital infection 59(3), 197-204.
10. Craven, F. R., Hirnle, J. C., Jensen, S. 2015. Hemşirelik esasları insan sağlığı ve fonksiyonları. (Çev. N. Uysal ve E. Çakırcalı). Ankara: Palme Yayıncılık. 464-487.
11. Curran, E. T., Coia, J. E., Gilmour, H., McNamee, S., Hood, J., 2000. Multi-center research surveillance project to reduce infection/phlebitis associated with peripheral vascular catheters. Journal of Hospital Infection 46(3), 194-202.
12. Do Rego Furtado, L. C., 2011. Incidence and predisposing factors of phlebitis in a surgery department. British Journal of Nursing 20(14), 16-25.
13. Erdoğan, C. B., Denat, Y., 2016. Periferik intravenöz kateter komplikasyonlarından flebit ve hemşirelik bakımı. Journal of Human Rhythm 2(1), 6-12
14. Gallant, P., Schultz, A. A. 2006. Evaluation of a visual infusion phlebitis scale for determining appropriate discontinuation of peripheral intravenous catheters. Journal of Infusion Nursing 29(6), 338-345.
15. Infusion Nurses Society. 2011. Infusion Nursing Standards of Practice. (The official publication of the Infusion Nurses Society). Journal of Infusion Nursing 34(1), 1-110.
16. Kuş, B., Büyükyılmaz, F., 2018. Visual infusion phlebitis assessment scale: Study of independent inter-observer compliance. Florence Nightingale Journal of Nursing 26(3), 179–186.
17. Lanbeck, P., Odenholt, I., Paulsen, O., 2004. Perception of risk factors for infusion phlebitis among Swedish Nurses: A questionnaire study. Journal of Infusion Nursing 27(1), 25-30.
18. Lundgren, A., Wahren, L.K., Ek. A. C., 1996. Peripheral intravenous lines: time in siturelated to complications. Journal of Infusion Nursing 19(5), 229-38.
19. Nyika, M. L., Mukona, D., Zvinavashe, M., 2018. Factors contributing to phlebitis among adult patients admitted in the medical-surgical units of a central hospital in Harare, Zimbabwe. Journal of Infusion Nursing 41(2), 96–102
20. Palefski, S. S., Stoddard, G. J., 2001. The infusion rate and patient complication rates of peripheral catheters. Journal of Infusion Nursing 24(2), 113-23.
21. Pasalioğlu, K. B., Kaya H., 2014. Catheter indwell time and phlebitis development during peripheral ıntravenous catheter administration. Pakistan Journal Medical Science 30(4),725–730.
22. Saini, R., Agnihotri, M., Gupta, A., Walia, I., 2011. Epidemiology of infiltration and phlebitis. Nursing and Midwifery Research Journal 7(1), 22-33.
23. Salgueiro-Oliveira, A., Parreira, P., Veiga, P., 2012. Incidence of phlebitis in patients with peripheral intravenous catheters: The influence of some risk factors. Australian Journal of Advanced Nursing 30(2), 32–39.
24. Sharp, R., Cummings, M., Fielder, A., Mikocka-Walus, A., Grech, C., Esterman, A., 2015. The catheter to vein ratio and rates of symptomatic venous thromboembolism in patients with a peripherally inserted central catheter (PICC): a prospective cohort study. International Journal of Nursing Studies 52, 677-85.
25. Simin, D., ilutinović, D., Turkulov Brkić S., 2019. Incidence, severity and risk factors of peripheral intravenous cannula induced complications: An observational prospective study. Journal of Clinical Nursing 28, 1585-1599.
26. Türk Hastane İnfeksiyonları ve Kontrolü Derneği, 2019. Ulusal Damar Erişimi Yönetimi Rehberi. Hastane İnfeksiyonları Dergisi. 23 (1), 1-54.
27. Urbanetto, J. S., May, T. A., 2016. Incidence of phlebitis associated with the use of peripheral IV catheter and following catheter removal. Latino-Americana de Enfermagem 24(2746), 1-9.
28. Uslusoy, E., Mete, S., 2008. Predisposing factors to phlebitis in patients with peripheral intravenous catheters: A descriptive study. Journal of the American Academy of Nurse Practitioners 20(4),172–180.
29. Wallis, M. C., McGrail, M., Webster, J., Marsh, N., Gowardman, J., Playford, E. G., Rickard, C. M., 2014. Risk factors for peripheral intravenous catheter failure: a multivariate analysis of data from a randomized controlled trial. Infection Control & Hospital Epidemiology 35(1),63-8.
30. Webster, J., McGrail, M., Marsh, N., Wallis, M. C., Ray-Barruel, G., Rickard, C. M., 2015. Postinfusion phlebitis: Incidence and risk factors. Nursing Research and Practice 691934, 1-3.