Department of Clinical Science, Intervention and Technology, Division of Surgery, Karolinska Institutet at Karolinska University Hospital Huddinge, Stockholm, Sweden.
J Eval Clin Pract. 2010 Dec;16(6):1108-15. doi: 10.1111/j.1365-2753.2009.01278.x.
To evaluate the extensive use of peripheral venous catheters (PVCs), including catheter-related complications, a reliable tool for PVC assessment is needed. The aim of this study was to develop such a tool to evaluate PVCs in relation to management, documentation and signs and symptoms of thrombophlebitis (TH), as well as to determine its inter-rater and test-retest reliability.
The tool development included confirmation of content and face validity. Two groups of registered nurses used the new tool (PVC assess) to assess PVC management and signs of TH independently. Group A (n=3) assessed 26 items in 67 PVCs bedside (inter-rater reliability). Group B (n=3) assessed photographs (67 PVCs, 21 items) of the same PVCs as those in Group A with a 4-week interval (test-retest reliability). Proportion of agreement P(A) and Cohen's kappa were calculated to evaluate inter-rater and test-retest reliability.
Among nurses assessing PVCs at bedside, the P(A) was good to excellent (0.80-1) in 96% of the items in PVC assess. In 80% of the items kappa was substantial to almost perfect (0.61-1). TH sign erythema fell into the fair range (kappa=0.40). In test-retest reliability analysis the P(A) was within the good and excellent range (0.80-1.0) and kappa varied from moderate to almost perfect (0.41-1.0) in 95% of the items. One item 'outer dressing is clean' was in fair range (0.21-0.40).
The PVC assess instrument shows satisfactory inter-rater and test-retest reliability. Reliability tests on reviewing documentation remain to be performed.
为了评估外周静脉导管（PVC）的广泛使用情况，包括导管相关并发症，需要一种可靠的 PVC 评估工具。本研究旨在开发一种工具，以评估与管理、记录以及血栓性静脉炎（TH）的症状和体征相关的 PVC，并确定其组内和重测信度。
工具的开发包括内容和表面有效性的确认。两组注册护士分别使用新工具（PVC assess）独立评估 PVC 管理和 TH 体征。A 组（n=3）床边评估了 67 个 PVC 中的 26 项（组内信度）。B 组（n=3）评估了与 A 组相同的 67 个 PVC 的照片（21 项），两次评估间隔 4 周（重测信度）。计算一致性比例 P(A)和 Cohen's kappa 以评估组内和重测信度。
在床边评估 PVC 的护士中，PVC assess 中 96%的项目具有良好到极好的一致性 P(A)（0.80-1）。80%的项目 kappa 值为中等至几乎完美（0.61-1）。TH 体征红斑属于中等范围（kappa=0.40）。在重测信度分析中，P(A)在良好到极好的范围内（0.80-1.0），kappa 值在 95%的项目中从中等到几乎完美（0.41-1.0）。一项“外层敷料干净”的项目属于中等范围（0.21-0.40）。
PVC assess 工具具有良好的组内和重测信度。对审查文件的可靠性测试仍有待进行。
