Torné-Ruiz Alba, Reguant Mercedes, Sanromà-Ortiz Montserrat, Piriz Marta, Roca Judith, García-Expósito Judith
Department of Nursing and Physiotherapy, University of Lleida, 25199 Lleida, Spain.
Hospital Fundació Althaia, Xarxa Assistencial Universitària de Manresa, 08243 Manresa, Spain.
Healthcare (Basel). 2024 Feb 1;12(3):378. doi: 10.3390/healthcare12030378.
Phlebitis related to peripheral venous catheters (PVCs) is a common complication in patients who require these devices and can have important consequences for the patients and the healthcare system. The management and control of the PVC-associated complications is related to nursing competency. The present study aims to determine, at the national level in Spain, the consensus on the assessment, treatment, and follow-up of PVC-related phlebitis and the importance of the actions taken.
A three-round Delphi technique was used with clinical care nurses who are experts in the field of in-hospital intravenous treatment in Spain. For this, an online questionnaire was developed with three open-ended questions on the dimensions of phlebitis assessment, treatment, and follow-up. For the statistical analysis of the results, frequencies and percentages were used to determine consensus, and the measures of central tendency (mean, standard deviation, and the coefficient of variation) were used to rank importance. The coefficient of variation was set as acceptable at ≤30%.
The final sample was 27 expert nurses. At the conclusion of round 3, actions were ranked according to their importance, with six items included in the PVC-related phlebitis assessment (symptomatology/observation, redness, the Maddox scale, induration, temperature, and pain), two in treatment (catheter removal, pentosan polysulphate sodium ointment + application of cold), and just one in follow-up (general monitoring + temperature control).
There is a major disparity in relation to the PVC-related phlebitis assessment, treatment, and follow-up actions. More clinical studies are therefore needed to minimise the complications associated with the use of PVCs, given their impact on the quality of care and patient safety and their economic cost.
与外周静脉导管（PVC）相关的静脉炎是需要使用这些装置的患者常见的并发症，可能对患者和医疗系统产生重大影响。PVC相关并发症的管理和控制与护理能力有关。本研究旨在确定西班牙全国范围内关于PVC相关静脉炎的评估、治疗和随访的共识以及所采取行动的重要性。
对西班牙医院内静脉治疗领域的临床护理专家使用三轮德尔菲技术。为此，开发了一份在线问卷，其中包含关于静脉炎评估、治疗和随访维度的三个开放式问题。对于结果的统计分析，使用频率和百分比来确定共识，并使用集中趋势度量（均值、标准差和变异系数）来对重要性进行排名。变异系数设定为≤30%时可接受。
最终样本为27名专家护士。在第3轮结束时，根据重要性对行动进行了排名，PVC相关静脉炎评估包括六项（症状/观察、发红、马多克斯量表、硬结、温度和疼痛），治疗包括两项（拔除导管、多磺酸粘多糖乳膏+冷敷），随访仅包括一项（一般监测+体温控制）。
在PVC相关静脉炎的评估、治疗和随访行动方面存在重大差异。因此，鉴于其对护理质量、患者安全及其经济成本的影响，需要更多的临床研究来尽量减少与使用PVC相关的并发症。
