Enhancing Phlebitis Detection In Paediatric Patients Through Routine Physician Inspections-A Prospective Observational Study
Keywords:
N\AAbstract
Background: Phlebitis (inflammation of the vein) is a common complication of peripheral intravenous (IV) cannulation, particularly among the pediatric population .Its prompt recognition is essential to avoid complications such as thrombophlebitis, bloodstream infections, and increased length of stay. Although nurses routinely monitor IV sites, doctors inspecting the IV sites may improve detection of phlebitis and minimize negative outcomes associated with the complication.
Objective: To assess the impact of a routine physician inspection of the peripheral IV site on the identification of phlebitis in hospitalized children at a tertiary care hospital and to determine risk factors related to the condition.
Methods: Twenty-four month prospective observational study was conducted at R.L. Jalappa Hospital & Research Centre. A total of 237 children (aged 1 month to 12 years) requiring IV cannulation were included. Phlebitis was determined using the Visual Infusion Phlebitis (VIP) score, and nurses monitored once every 8 hours (3 times daily) and doctors inspected twice daily. The FLACC and Wong-Baker pain scores were used when appropriate.
Results:A total of 237 children were assessed, with phlebitis diagnosed in 33 samples (13.92%). The nurse detected 14 phlebitis cases (5.9%), and the doctor identified 19 phlebitis cases; however, the statistical significance showed that the number of cases the doctor identified was higher than the number of samples the nurse identified (p < 0.05). More phlebitis was observed in younger children (≤3 years).
Conclusion: Regularly performed physician inspection was superior to nursing alone in detecting phlebitis in children. Since younger children are more likely to develop phlebitis, monitoring is vital. There is a need to explore a dual surveillance model that incorporates nursing and physician assessment to prevent diagnosis from being missed. It is expected that the clinical outcome will also improve..
Downloads
References
Robert M, Jose B, John S. Impact of Physician Inspection in the Detection of Phlebitis and Factors Contributing to it in Admitted Children of a Tertiary Care Hospital: A Prospective Study. Indian J Pediatr. 2021;88(4):358–62.
Miliani K, Taravella R, Thillard D, Chauvin V, Martin E, Edouard S, et al. Peripheral Venous Catheter-Related Adverse Events: Evaluation from a Multicentre Epidemiological Study in France (the CATHEVAL Project). PLoS One. 2017;12(1):e0168637.
Tripathi S, Kaushik V, Singh V. Peripheral IVs. Journal of Infusion Nursing. 2008;31(3):182–8.
Ray‐Barruel G, Polit DF, Murfield JE, Rickard CM.Infusion phlebitis assessment measures: a systematic review. J Eval Clin Pract. 2014;20(2):191–202.
Gallant PBRSAA.Evaluation of a Visual Infusion Phlebitis Scale for Determining Appropriate Discontinuation of Peripheral Intravenous Catheters. Journal of infusion nursing. 2006;29(6):338-45.
Sengupta M. Use of visual infusion phlebitis (VIP ) score to care and control intravenous (IV) infusion-related phlebitis. International Journal of Integrative Medical Sciences. 2019 ;6(5):836–8.
Jackson A. Infection control: a battle in vein infusion phlebitis. Nurs Times. 1998;94(4):68–71.
Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S. The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatr Nurs. 1997;23(3):293-7.
Wong DL, Baker CM. Pain in children: comparison of assessment scales. Pediatr Nurs. 1998;14:9–17.
Andriyani R, Satari HI, Amalia P. Duration of peripheral intravenous catheter use and development of phlebitis. Paediatr Indones. 2013;53(2):117
Sumathy P, Finny. A study to assess the risk factors of developing thrombophlebitis among children admitted in paediatric ward in a selected hospital at Puducherry. Int J Health Sci Res. 2016;7(6):250-253.
Nikhila T, Mohan PL, Mohammed Salim K, Aravind RS.Intravenous cannula induced phlebitis in a tertiary care referral hospital: A prospective observational study with implication from patient’s feedback system. J Healthc Qual Res. 2022;37(6):357–65.
Resnick O, Abu Ahmad W, Bancovsky D, Rogachev S, Ashash A, Ohana Sarna Cahan L, et al. Predicting factors for complications in peripheral intravenous catheters in the pediatric population. Acta Paediatr. 2021;110(5):1639–44.
Kumar P, Dhar A, Banik S, Saha A, Amrita Banik, Biswas P, et al. Incidence of phlebitis among children having peripheral intravenous line in selected hospital, Siliguri. Int J Contemp Pediatrics. 2023;10(9):1431–5.
Mandal A, Raghu K. Study on incidence of phlebitis following the use of peripheral intravenous catheter. J Family Med Prim Care. 2019;8(9):2827.
Kaphan K, Auypornsakul S, Somno J, Wongwattananan W, Jamsittikul K, Baicha W, et al. The Prevalence and Associated Factors of Peripheral Intravenous Complications in a Thai Hospital. Journal of Infusion Nursing. 2024;47(2):120–31.
Shinzato Y, Yasuda H, Moriya T, Taira H, Kishihara Y, Kashiura M, et al.Risk factors of phlebitis in patients admitted to the intensive care unit vary according to the duration of catheter dwelling: A post-hoc analysis of the AMOR-VENUS study. PLoS One. 2025;20(4):e0320583.
Kaur P, Thakur R, Kaur S, Bhalla A. Assessment of risk factors of phlebitis amongst intravenous cannulated patients. Nursing & Midwifery Research Journal. 2011;7(3):106–14.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
