title: Infusion phlebitis assessment measures: a systematic review.
abstract: OBJECTIVE
  Phlebitis is a common and painful complication of peripheral intravenous cannulation. The aim of this review was to identify the measures used in infusion phlebitis assessment and evaluate evidence regarding their reliability, validity, responsiveness and feasibility.
  
  
  METHODS
  We conducted a systematic literature review of the Cochrane library, Ovid MEDLINE and EBSCO CINAHL until September 2013. All English-language studies (randomized controlled trials, prospective cohort and cross-sectional) that used an infusion phlebitis scale were retrieved and analysed to determine which symptoms were included in each scale and how these were measured. We evaluated studies that reported testing the psychometric properties of phlebitis assessment scales using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines.
  
  
  RESULTS
  Infusion phlebitis was the primary outcome measure in 233 studies. Fifty-three (23%) of these provided no actual definition of phlebitis. Of the 180 studies that reported measuring phlebitis incidence and/or severity, 101 (56%) used a scale and 79 (44%) used a definition alone. We identified 71 different phlebitis assessment scales. Three scales had undergone some psychometric analyses, but no scale had been rigorously tested.
  
  
  CONCLUSIONS
  Many phlebitis scales exist, but none has been thoroughly validated for use in clinical practice. A lack of consensus on phlebitis measures has likely contributed to disparities in reported phlebitis incidence, precluding meaningful comparison of phlebitis rates.
authors.affiliation: NHMRC Centre for Research Excellence in Nursing, Centre for Health Practice Innovation, Griffith Health Institute, Griffith University, Brisbane, Queensland, Australia.
authors.forename: Gillian
authors.initials: G
authors.lastname: Ray-Barruel
authors.forename: Denise F
authors.initials: DF
authors.lastname: Polit
authors.forename: Jenny E
authors.initials: JE
authors.lastname: Murfield
authors.forename: Claire M
authors.initials: CM
authors.lastname: Rickard
mesh_terms: D002406:Catheterization, Peripheral / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D006801:Humans; D015994:Incidence; D010689:Phlebitis / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D011594:Psychometrics; D015203:Reproducibility of Results
keywords: assessment; measurement; peripheral intravenous catheter; phlebitis; psychometric assessment; scales