Implementation of the Visual Infusion Phlebitis Score (VIP Score)
By CHUNG Yuen Chi, Samantha, RN, BSc (Hons) in Nursing, MNurs Ward 33/F
To develop a tool that provides a standardized method for nurses to assess intravenous puncture sites and communicate about the phlebitis progression.
Many patients have intravenous catheters for various treatments. Phlebitis is a common complication of having intravenous catheters. Phlebitis is not only causing pain, it could also interrupt the prescribed therapy and lead to bloodstream infection. However, the current practice is primarily reliant upon nurses’ experience and handover for continuous intravenous puncture site. There is no standard scale to assess for continuous IV site monitoring. Therefore, an early detection of complications and removal of the IV catheter is crucial. An evidence-based practice project as conducted to determine whether the VIP Score could help nurses in continuous monitoring of intravenous puncture sites.
A survey focusing on nursing practice on assessment, difficulties faced on nursing assessment and knowledge on caring of intravenous puncture sites was conducted. Questionnaire consisted of 5-points rating scale questions were disturbed to nurses in mixed medical /surgical wards. After collection of the pre-implementation survey data, the VIP Score were introduced to them. VIP Score badges were distributed and VIP Score signs were posted in nursing station as reminders. Then, a follow-up survey was done and feedbacks about using the VIP Score were also collected.
A significant increase in knowledge about severe phlebitis condition was noted. Nurses were having positive feedbacks towards using of the VIP Score. 85% of nurses reported that the VIP Score was easy to use in clinical setting, 80% of nurses claimed that the VIP Score facilitating them in deciding actions to take on different phlebitis condition, 80% of nurses agreed that the VIP Score facilitating them in describing and documenting phlebitis condition, while 85% of nurses also agreed that the VIP Score facilitated them in continuous monitoring on phlebitis condition from shift to shift.
The VIP Score facilitates nurses in continuous intravenous puncture site monitoring in mixed medical /surgical wards. However, the survey size is relatively small. It could provide more relevant results if a coming survey would be done in different units under different specialties. Hopefully, the VIP Score would be promoted as a usual practice in clinical use and helping all nurses with a better understanding and management of the intravenous puncture sites.