COSMIN database

Infusion phlebitis assessment measures: a systematic review

Ray-Barruel, G., Polit, D. F., Murfield, J. E., and Rickard, C. M.

AIMS AND OBJECTIVES: 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.

METHOD: 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.

CONCLUSION: 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.
J Eval Clin Pract
1365-2753 (Electronic)
Publication year:
Symptom status:
Physical state
Adults (18-65)
Seniors (65+)
Certain infections and parasitic diseases and related symptoms
Diseases of and symptoms related to the circulatory system
PRO / non-PRO:
Non-patient Reported Outcome
Type of measurement instrument:
6 - Clinical rating scales
7 - Observations
Baxter score
Dinley scale
INS - Infusion Nurses Society phlebitis scale
Lipman scale
Maddox scale
Modified DeLuca and Maddox scale
Modified INS scale - Modified Infusion Nurses Society Scale
Modified Phlebitis Rating Scale
PVC Assess - Peripheral Venous Catheters assess
Scale 0-3
VIP score - Visual Infusion Phlebitis score