{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T22:53:21Z","timestamp":1783032801798,"version":"3.54.6"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,7,17]],"date-time":"2015-07-17T00:00:00Z","timestamp":1437091200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP481934"],"award-info":[{"award-number":["APP481934"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Rationale, aims and objectives<\/jats:title><jats:p>Many peripheral intravenous catheter (<jats:styled-content style=\"fixed-case\">PIVC<\/jats:styled-content>) infusion phlebitis scales and definitions are used internationally, although no existing scale has demonstrated comprehensive reliability and validity. We examined inter\u2010rater agreement between registered nurses on signs, symptoms and scales commonly used in phlebitis assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Seven <jats:styled-content style=\"fixed-case\">PIVC<\/jats:styled-content>\u2010associated phlebitis signs\/symptoms (pain, tenderness, swelling, erythema, palpable venous cord, purulent discharge and warmth) were observed daily by two raters (a research nurse and registered nurse). These data were modelled into phlebitis scores using 10 different tools. Proportions of agreement (e.g. positive, negative), observed and expected agreements, <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ohen's kappa, the maximum achievable kappa, prevalence\u2010 and bias\u2010adjusted kappa were calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred ten patients were recruited across three hospitals, with 247 sets of paired observations undertaken. The second rater was blinded to the first's findings. The <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>atney and <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>ittenberg scales were the most sensitive (phlebitis in &gt;20% of observations), whereas the <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>urran, <jats:styled-content style=\"fixed-case\">L<\/jats:styled-content>anbeck and <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>ickard scales were the most restrictive (\u22642% phlebitis). Only tenderness and the <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>atney (one of pain, tenderness, erythema or palpable cord) and <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>ittenberg scales (one of erythema, swelling, tenderness or pain) had acceptable (more than two\u2010thirds, 66.7%) levels of inter\u2010rater agreement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Inter\u2010rater agreement for phlebitis assessment signs\/symptoms and scales is low. This likely contributes to the high degree of variability in phlebitis rates in literature. We recommend further research into assessment of infrequent signs\/symptoms and the <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>atney or <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>ittenberg scales. New approaches to evaluating vein irritation that are valid, reliable and based on their ability to predict complications need exploration.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jep.12396","type":"journal-article","created":{"date-parts":[[2015,7,17]],"date-time":"2015-07-17T07:03:48Z","timestamp":1437116628000},"page":"893-899","source":"Crossref","is-referenced-by-count":40,"title":["Inter\u2010rater agreement on <scp>PIVC<\/scp>\u2010associated phlebitis signs, symptoms and scales"],"prefix":"10.1111","volume":"21","author":[{"given":"Nicole","family":"Marsh","sequence":"first","affiliation":[{"name":"Centre for Clinical Nursing Royal Brisbane and Women's Hospital  Herston Queensland Australia"},{"name":"NHMRC Centre for Research Excellence in Nursing Menzies Health Institute Queensland Griffith University  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabor","family":"Mihala","sequence":"additional","affiliation":[{"name":"NHMRC Centre for Research Excellence in Nursing Menzies Health Institute Queensland Griffith University  Brisbane Queensland Australia"},{"name":"School of Medicine Griffith Health Institute Griffith University  Meadowbrook Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8875-7523","authenticated-orcid":false,"given":"Gillian","family":"Ray\u2010Barruel","sequence":"additional","affiliation":[{"name":"NHMRC Centre for Research Excellence in Nursing Menzies Health Institute Queensland Griffith University  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Webster","sequence":"additional","affiliation":[{"name":"Centre for Clinical Nursing Royal Brisbane and Women's Hospital  Herston Queensland Australia"},{"name":"NHMRC Centre for Research Excellence in Nursing Menzies Health Institute Queensland Griffith University  Brisbane Queensland Australia"},{"name":"School of Nursing and Midwifery University of Queensland  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne C.","family":"Wallis","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery University of the Sunshine Coast  Maroochydore Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire M.","family":"Rickard","sequence":"additional","affiliation":[{"name":"Centre for Clinical Nursing Royal Brisbane and Women's Hospital  Herston Queensland Australia"},{"name":"NHMRC Centre for Research Excellence in Nursing Menzies Health Institute Queensland Griffith University  Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,7,17]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/NAN.0b013e31825af099"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.12968\/bjon.1998.7.21.5551"},{"issue":"36","key":"e_1_2_6_4_1","first-page":"18","article-title":"Phlebitis: treatment, care and prevention","volume":"107","author":"Higginson R.","year":"2011","journal-title":"Nursing Times"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1086\/674398"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcn078"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00129804-200701000-00006"},{"key":"e_1_2_6_8_1","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1001\/archinte.1984.00350190057010","article-title":"The natural history of intravenous catheter\u2010associated phlebitis","volume":"144","author":"Hershey C. 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