Interrater agreement of the classification of phlebitis, its signs, and symptoms in peripheral intravenous catheters
Abstract
Introduction: Although various tools for assessing the presence and severity of complications associated with CVPs have been described in the literature, standardised guidelines are still lacking and further research is required.
Objetive: The objective of this study was to determine inter-rater agreement for the classification of phlebitis, its signs, and symptoms using the Visual Infusion Phlebitis Scale.
Material and methods: This was a prospective cohort study of patients aged 18 years and older hospitalized in an emergency department with their first peripheral venous catheter in place. Signs and symptoms of phlebitis were assessed daily using the scale. A descriptive analysis was performed, and agreement for the classification of phlebitis, its signs, and symptoms was calculated using Cohen's Kappa coefficient.
Results: 817 patients were included. The most common sign or symptom was erythema (13.59%), followed by pain (11.50%), edema (2.99%), and induration (2.02%). There was no palpable venous cord or pyrexia. The overall incidence of phlebitis was 11.44%; grade II (9.42%) and grade III (2.02%). Cohen's Kappa coefficient was 0.990 (95% CI 0.982–0.996) for the general classification of phlebitis. The highest reproducibility for signs and symptoms was pain (k=0.946), followed by induration (k=0.894), edema (k=0.716), and erythema (k=0.649).
Conclusions: This study showed high inter-rater agreement overall for the scale and good to very good agreement for each sign and symptom.
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