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BMC Health Serv Res. 2019 Sep 5;19(1):636. doi: 10.1186/s12913-019-4497-z.

Monitoring quality of care for peripheral intravenous catheters; feasibility and reliability of the peripheral intravenous catheters mini questionnaire (PIVC-miniQ).

Høvik LH1,2,3, Gjeilo KH4,5,6, Lydersen S7, Rickard CM8,9, Røtvold B10, Damås JK11,12,13, Solligård E4,11,14, Gustad LT4,11,15.

Author information

1
Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway. lise.hovik@ntnu.no.
2
Gemini Center for Sepsis Research, St. Olavs Hospital and Norwegian University of Science and Technology (NTNU), Trondheim, Norway. lise.hovik@ntnu.no.
3
Clinic of Anaesthesia and Intensive Care, St. Olavs Hospital, Trondheim, Norway. lise.hovik@ntnu.no.
4
Department of Circulation and Medical Imaging, Norwegian University of Science and Technology (NTNU), Postbox 8905, 7491, Trondheim, Norway.
5
Department of Cardiothoracic Surgery, Department of Cardiology and National Competence Centre for Complex Symptom Disorders, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
6
Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
7
Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
8
Alliance for Vascular Access teaching and Research, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.
9
School of Nursing and Midwifery, Griffith University, Brisbane, Australia.
10
Department of Anesthesia, Levanger Hospital, Clinic of Surgery, Nord-Trøndelag Hospital Trust, Levanger, Norway.
11
Gemini Center for Sepsis Research, St. Olavs Hospital and Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
12
Centre of Molecular Inflammation Research, Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway.
13
Department of Infectious Diseases, St. Olavs Hospital, Trondheim, Norway.
14
Clinic of Anaesthesia and Intensive Care, St. Olavs Hospital, Trondheim, Norway.
15
Department of Medicine, Levanger Hospital, Clinic of Medicine and rehabilitation, Nord-Trøndelag Hospital Trust, Levanger, Norway.

Abstract

BACKGROUND:

Peripheral intravenous catheters (PIVCs) account for a mean of 38% of catheter associated bloodstream infections (CABSI) with Staphylococcus aureus, which are preventable if deficiencies in best practice are addressed. There exists no feasible and reliable quality surveillance tool assessing all important areas related to PIVC quality. Thus, we aimed to develop and test feasibility and reliability for an efficient quality assessment tool of overall PIVC quality.

METHODS:

The Peripheral Intravenous Catheter- mini Questionnaire, PIVC-miniQ, consists of 16 items calculated as a sum score of problems regarding the insertion site, condition of dressing and equipment, documentation, and indication for use. In addition, it contains background variables like PIVC site, size and insertion environment. Two hospitals tested the PIVC-miniQ for feasibility and inter-rater agreement. Each PIVC was assessed twice, 2-5 min apart by two independent raters. We calculated the intraclass correlation coefficient (ICC) for each hospital and overall. For each of the 16 items, we calculated negative agreement, positive agreement, absolute agreement, and Scott's pi.

RESULTS:

Sixty-three raters evaluated 205 PIVCs in 177 patients, each PIVC was assessed twice by independent raters, in total 410 PIVC observations. ICC between raters was 0.678 for hospital A, 0.577 for hospital B, and 0.604 for the pooled data. Mean time for the bedside assessment of each PIVC was 1.40 (SD 0.0007) minutes. The most frequent insertion site symptom was "pain and tenderness" (14.4%), whereas the most prevalent overall problem was lack of documentation of the PIVC (26.8%). Up to 50% of PIVCs were placed near joints (wrist or antecubital fossae) or were inserted under suboptimal conditions, i.e. emergency department or ambulance.

CONCLUSIONS:

Our study highlights the need for PIVC quality surveillance on ward and hospital level and reports the PIVC-miniQ to be a reliable and time efficient tool suitable for frequent point-prevalence audits.

KEYWORDS:

Peripheral intravenous catheter; Quality assessment; Quality improvement

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