Early detection of infusion phlebitis
Abstract:
Introduction: Peripherally-inserted venous catheters (PIVC) are essential for cancer patients to receive treatment. Phlebitis is a major complication of PIVC. Currently, nurses’ assessment of phlebitis mainly involves visual inspection. However, the latest literature suggests palpation for tenderness to promote the early detection of phlebitis.
Objectives: This project evaluated the effectiveness of a bundle approach to increase nurses’ compliance with PIVC site assessment to promote early detection of phlebitis (grade 2 and above).
Methods: The JBI Evidence Implementation Framework was used to conduct this project in a 28-bed hematology-oncology ward in a Singapore hospital. The bundle approach used in this project consisted of a training presentation, medical mannequin, and phlebitis scale card. The rate of nurses’ compliance with best practice for PIVC site assessment was measured at 1 month and 6 months post-implementation. The incidence of phlebitis was monitored up until 12 months post-implementation.
Results: Baseline data indicated that only 18.75% (3 out of 16) nurses palpated for tenderness when assessing for phlebitis. Data at 1 month and 6 months post-implementation reported sustained high compliance rates of 85.71% (24 out of 28) and 89.29% (25 out of 28), respectively. Late detection of phlebitis was reduced by 66% (from three cases to one case) at 6 months post-implementation, and no patients required invasive interventions.
Conclusions: The bundle approach used in this project facilitated early detection of phlebitis following the inclusion of palpation into nurses’ assessment for phlebitis.
Reference:
Toh SW, Tamarra RMA, Goh YX, Chang YQ, Hollen VT, Ng IXQ, Ahmad NM, Tho PC, Lee YM. Early detection of phlebitis among hematology-oncology patients: a best practice implementation project. JBI Evid Implement. 2024 May 10. doi: 10.1097/XEB.0000000000000429. Epub ahead of print. PMID: 38721758.