Symptomatic Management of phlebitis on peripheral venous catheters: A national survey of nursing practice.

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Guillaume BROUILLET, Axel DI VITTORIO, Elisabeth PINSON, Geoffroy ROUSSEAU, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4598400/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: There are no international guidelines for the symptomatic management of phlebitis on peripheral venous catheters. Nurses therefore propose heterogeneous and low evidence-based management strategies to treat this complication. To explore the various management approaches for phlebitis on peripheral venous catheters proposed by registered nurses in France. Methods: Registered nurses and nurse executive practicing in both public and private sectors in France were invited to respond to a survey on the management of phlebitis on peripheral catheters. This survey was developed by nurses, nurse executive, and a physician. The survey was distributed via email through the National Order of Nurses from March 31, 2023, to April 30, 2023. No follow-up was conducted. A descriptive analysis of the survey results was then performed. Results: 3,038 healthcare providers practicing in 4 French regions responded to the survey. Phlebitis on peripheral venous catheters is most frequently encountered in medical wards. Respondents to the survey used heterogeneous strategies for the symptomatic treatment of phlebitis on peripheral venous catheters. 70° Alcohol dressings was the most common strategy reported (85.75% of respondents), applied for 92.40% of respondents without a medical prescription. The duration of treatment and its daily frequency of use were also highly variable. Conclusion: Nursing practices for the symptomatic treatment of this complication are highly heterogeneous in France, often conducted without medical prescription, although the use of 70° alcohol dressing is considered as a medication in France, which could be debated. Nursing practice phlebitis peripheral venous catheter treatments survey Introduction The insertion of a peripheral venous catheter (PVC) is one of the most commonly performed procedures by nurses in the hospital setting [ 1 ]. In the United States alone, 330 million peripheral venous catheters (PVCs) are used annually [ 2 , 3 ], and globally, this number is estimated to exceed 2 billion. This type of equipment is used to facilitate the administration of medical products that cannot be given orally, including hydroelectrolytic balance, medications, and nutrition [ 4 ]. Several complications are possible, including catheter obstruction, extravasation, thrombosis, hematoma at the puncture site, and phlebitis [ 5 , 6 ]. These events may require local care, the administration of specific treatments, and can cause significant discomfort for the patient, prolonged hospitalization, and even lead to serious infectious complications such as bacteremia, especially in the case of phlebitis [ 7 , 8 ]. Phlebitis on a PVC is an inflammation of the inner wall of a vein called the "intima" developed in response to tissue damage caused by factors associated with the insertion and use of the PVC and the medications administered through it [ 9 ]. The intima is primarily composed of endothelial cells, which, when injured or irritated, trigger the release of histamines, bradykinin, and serotonin. This leads to a painful response and dilates the vein, causing swelling and sensitivity [ 6 , 10 ]. Phlebitis can be classified into 3 categories: mechanical, when the phlebitis is related to the action of the PVC on the vein; chemical, when it is related to medications; and bacterial, when it is related to contamination at the insertion site, intravenous solution, or tubing [ 6 , 10 ]. Studies measuring the rate of phlebitis on PVCs present heterogeneous results. The use of different outcome criteria in these studies may explain this disparity, with an incidence of phlebitis on PVCs ranging from 6 to 70% according to the studies [ 11 – 13 ]. The classic risk factors associated are insufficient asepsia during insertion, prolonged duration of PVC placement, and inadequate local monitoring [ 14 ]. Other factors can also increase the risk of phlebitis on PVCs, such as the catheter insertion site, catheter size, as well as the advanced age of infused patients [ 15 , 16 ]. To prevent phlebitis on PVCs, international guidelines advocate for limiting the indications for PVC insertion, ensuring strict asepsia before catheter placement, selecting the appropriate antiseptic (alcoholic antiseptic), limiting the duration of PVC placement, and closely monitoring skin condition through transparent dressings, among others [ 17 , 18 ]. Currently, while it is recommended to remove the PVC upon detection of phlebitis [ 4 , 19 ], there are no specific guidelines for the symptomatic management of phlebitis on PVCs. Therapeutic options often vary depending on the centers or individuals, with the use of various treatments with a low level of evidence, such as Aloe Vera [ 20 ], sesame oil [ 10 ], and glycerin magnesium sulphate dressing [ 21 ]. Nurses, who are responsible for inserting, maintaining, and monitoring PVCs, also play a role in restoring patients' health [ 4 , 9 ]. Currently, there are several scales available to identify signs of phlebitis on PVCs and monitor its progression, such as the Visual Infusion Phlebitis (VIP) [ 22 ] scale and the MADDOX scale [ 23 ]. To our knowledge, there is any literature surveying nursing practices describing the habits of healthcare providers in treating this common complication. Our study therefore aimed primarily to identify the treatments used by healthcare providers in France in managing phlebitis on PVCs.We had three secondary objectives in this survey: 1/ to determine whether the treatments used in this complication were applied with or without a medical prescription; 2/ to understand the modalities of use of treatments applied for phlebitis on PVCs; and 3/ to evaluate the satisfaction of healthcare providers with the effectiveness provided by the treatments used in this complication. Methods Study design To gather a large amount of data directly from the field over a short period, we chose to conduct a national practice survey. To establish current nursing practices in France regarding the symptomatic treatment of phlebitis, we initially searched the Enhancing the Quality and Transparency of Health Research (EQUATOR) network [ 24 ], for guidelines on conducting a practice survey. Within the framework of this observational study, the STROBE checklist (See Additional file 1) [ 25 ] was followed. Therefore, we conducted this practice survey using a standardized online questionnaire via the website: https://www.lesphinx-developpement.fr/ . The questionnaire was developed multidisciplinary (nurse, physician, nurse executive) and was tested on a sample of nurses within the hospital where the survey was developed before its national distribution. Following feedback from the nurses who tested the survey and considering their remarks on sometimes ambiguous question formulations, we finalized our questionnaire ready for national distribution. Survey tool The final version of the questionnaire included an introduction explaining the context of phlebitis on peripheral venous catheters and the objectives of the survey. Responses to the questionnaire were anonymous, and respondents were asked to provide their express consent by checking a box before filling out the questionnaire (See Additional file 2). The first three questions focused on the respondent's role, the type of facility, and the specialty in which they worked. The second part of the questionnaire was based on epidemiological data, with four questions regarding the number of patients cared for by the respondent, the number of patients receiving infusions, and the number of phlebitis cases observed in the month preceding the questionnaire. A third part of the questionnaire listed the treatments used for phlebitis on peripheral venous catheters with eight questions for this purpose. The first-line treatment used for phlebitis on PVCs, the modalities of treatment use, the presence of a medical prescription or not, the use of a scale to evaluate phlebitis symptoms, and the assessment of the effectiveness of the treatment used were asked. The survey comprised mandatory response questions except for the one asking for the number of beds available in the respondent's department or where the healthcare professional works. Indeed, caregivers with cross-cutting missions may work in several departments on the same day and work in others on another day. Therefore, it was not possible for them to specify the number of beds for each department. Ethical Considerations The questionnaire was submitted to the General Data Protection Regulation (GDPR). Since the data of the participants collected were anonymized, it was not possible to trace their identity. Therefore, no agreement from the National Commission on Informatics and Liberty (CNIL) was necessary for the realization of this survey. Ethical opinion was sought from the Ethics Reflection Space of the Centre-Val de Loire Region (ERERC) regarding the use of the data collected from the survey. Favorable opinion was granted on October 10, 2023 for this project referenced under number 2023 042. Sample This practice survey was aimed at registered nurses with a state diploma registered with the National Order of Nurses (ONI) in France, to obtain precise and objective responses on a recurring complication for which they are responsible for monitoring. The Presidents of the Regional Councils of the ONI were contacted by email to send our practice survey to the members registered in their respective regions. The survey was thus distributed via email with the agreements of the presidents of the Centre-Val de Loire, Nouvelle-Aquitaine, Auvergne-Rhône-Alpes regions, and in the Overseas Departments (La Réunion and Mayotte). It was possible to respond to the survey from March 31, 2023, to April 30, 2023. No email reminders were sent. • Data Analysis The anonymized data collected on the website https://www.lesphinx-developpement.fr/ were extracted and converted into an Excel file (2010 version) for analysis. The responses to the survey questions were described using frequencies and percentages for qualitative variables. We compared satisfaction level according treatment using a Chi-square test for hypothesis testing, the "p" value indicated a significant difference if it was ≤ 0.05. Results In total, the questionnaire was sent to 126,297 nurses. Among them, we received 3,038 responses, representing a response rate of 2.41%. Population Characteristics Registered nurses with the ONI can work in various settings, different departments, and may have progressed into roles such as nurse executive, hygiene referent, or others (Operating room nurses, nurse anesthetist, advanced practice nurse, pediatric nurse, nurse educator, manager of a Medico-Social Facility). Among the facilities where caregivers responded most to this survey, we mainly find those working in medicine services (29.26%) and surgery services (13.53%) (See Table 1 ). Table 1 Distribution of caregivers according to their practice settings Professions Structures Totals by professions, n (%) Hospital center, n (%) Private practice, n (%) University hospital center, n (%) Other healthcare or medical-social structures, n (%) Private clinic, n (%) Nurse 832 (27.39) 743 (24.46) 502 (16.52) 430 (14.15) 363 (11.95) 2870 (94.47) Nurse executive 24 (0.79) 1 (0.03) 6 (0.20) 30 (0.99) 16 (0.53) 77 (2.53) Hygiene referent 24 (0.79) 2 (0.07) 8 (0.27) 20 (0.66) 7 (0.22) 61 (2.01) Other 11 (0.36) 0 (0%) 11 (0.36) 6 (0.20) 2 (0.07) 30 (0.99) Totals by structures 891 (29.33) 746 (24.56) 527 (17.35) 486 (16) 388 (12.77) 3038 (100) Numbers (n) and percentages (%) Reported frequency of phlebitis on peripheral venous catheters (See Table 2 and Additional file 3) Table 2 highlights that 1677 (55.20%) of respondents reported observing at least one phlebitis in the month preceding the survey. Table 2 Distribution of the number of reported phlebitis on PVCs by respondents Number of reported phlebitis on PVCs by respondents Specialties of respondents Total, n (%) Medicine , n (%) Surgery , n (%) Private Practice , n (%) Emergency , n (%) *Other , n (%) 0 165 (5.43) 80 (2.63) 603 (19.85) 74 (2.44) 439 (14.45) 1361 (44.80) 1–5 555 (18.27) 268 (8.82) 135 (4.44) 75 (2.47) 350 (11.52) 1383 (45.52) 6–10 124 (4.08) 50 (1.65) 1 (0.03) 15 (0.49) 28 (0.92) 218 (7.18) > 10 45 (1.48) 13 (0.43) 3 (0.10) 5 (0.16) 10 (0.33) 76 (2.50) **Total respondents 889 (29.26) 411 (13.53) 742 (24.42) 169 (5.56) 827 (27.22) 3038 (100) Numbers (n) and percentages (%) *The "other" column in Table 2 groups together 19 specialties (Additional file 3), such as respondents working in intensive care units, in correctional facilities, in rehabilitation centers, etc. **The total respondents correspond to the number of respondents per specialty who observed phlebitis on PVCs in the month preceding the survey. Medicine services are the specialty where respondents reported the most phlebitis on PVCs in the month preceding the survey. The specialty of medicine had the highest number of patients on infusion therapy on the day respondents answered the questionnaire, with a total of 10,473 patients, followed by surgical services with 6,351 patients on infusion therapy. Emergency departments followed with 4,961 patients on infusion therapy, and 949 patients received care in outpatient settings. Other specialties accounted for 6,820 patients on infusion therapy. Symptomatic treatments for phlebitis related to peripheral venous catheters: Various treatments were utilized among the survey respondents in managing phlebitis related to PVCs apart from catheter removal. (See Table 3 ) Six treatments were the most frequently mentioned by respondents. Among other treatments applied, 33 different management approaches were described (Additional file 4), primarily involving the use of 30% glucose compress and glycerin alcohol. Some also reported not using any treatment for this complication. Table 3 List of treatments used by respondents for symptomatic management of phlebitis besides removing the implicated catheter Treatments used Medical prescription Total, n (%) Non-prescription care , n (%) Prescription-based care , n (%) 70° alcohol dressing 2407 (79.23) 198 (6.52) 2605 (85.75) Lidocaine-based cream 76 (2.50) 14 (0.46) 90 (2.96) Cold pack 71 (2.34) 9 (0.30) 80 (2.63) Nonsteroidal anti-inflammatory cream 16 (0.53) 3 (0.10) 19 (0.63) Simple emollient 8 (0.26) 3 (0.10) 11 (0.36) Corticosteroid-based cream 2 (0.07) 6 (0.20) 8 (0.26) Other treatments 125 (4.11) 32 (1.05) 157 (5.17) No treatment 49 (1.61) 19 (0.63) 68 (2.24) Totals 2754 (90.65) 284 (9.35) 3038 (100) Numbers (n) and percentages (%) Results presented in Table 3 also highlight the use of a medical prescription or not in the treatments used by survey respondents for phlebitis on PVCs. The 70° alcohol dressing was the most commonly used treatment by respondents, and was used without a medical prescription in more than 90% of cases. Generally, for the six most cited treatments, 91.72% of respondents declared not using a medical prescription. Modalities of symptomatic treatments applied for phlebitis The duration of symptomatic treatment for phlebitis on PVCs varied. Indeed, although using the same treatment, healthcare providers applied it for either 1 to 7 days or continue until the symptoms disappearance (redness, warmth, swelling, pain), with 60.46% of them not specifying the exact number of days. Treatment was administered twice a day for 39.43% of respondents (See Table 4 ). Table 4 Daily utilization methods of treatments in the management of phlebitis on PVCs Treatments Used Number of applications per day Total, n (%) Once daily , n (%) Twice daily , n (%) Three times daily , n (%) Four times daily , n (%) As needed by the patient , n (%) 70° alcohol dressing 402 (15,43) 1039 (39,88) 569 (21,84) 137 (5,26) 458 (17,58) 2605 (87,71) Lidocaine-based cream 24 (0,81) 36 (1,21) 11 (0,37) 2 (0,07) 17 (0,57) 90 (3,03) Cold pack 6 (0,20) 25 (0,84) 11 (0,37) 6 (0,20) 32 (1,08) 80 (2,69) Nonsteroidal anti-inflammatory cream 1 (0,03) 10 (0,34) 4 (0,13) 0 (0) 4 (0,13) 19 (0,64) Simple emollient 1 (0,03) 1 (0,03) 3 (0,10) 1 (0,03) 5 (0,17) 11 (0,37) Corticosteroid-based cream 3 (0,10) 5 (0,17) 0 (0) 0 (0) 0 (0) 8 (0,27) Other treatments 33 (1,11) 55 (1,85) 35 (1,18) 5 (0,17) 29 (0,98) 157 (5,29) Totals* 470 (15,82) 1171 (39,43) 633 (21,31) 151 (5,08) 545 (18,35) 2970 (100) Numbers (n) and percentages (%) *Totals calculated only with respondents using symptomatic treatment for phlebitis on PVCs (those not using any treatment were not included in the table) Perception of treatment effectiveness by healthcare providers (See Table 5 ) Table 5 describes the satisfaction of healthcare providers about the treatment effectiveness according to management strategy. Considering the evaluation of management effectiveness, 98.39% of respondents reported not using a standardized scale to evaluate phlebitis (example: The Visual Infusion Phlebitis scale) (22). Table 5 Satisfaction of healthcare providers in the effectiveness of treatments used for phlebitis on PVCs Treatments Used Satisfaction Total, n (%) Not satisfied at all , n (%) Slightly satisfied , n (%) Satisfied , n (%) Very satisfied , n (%) 70° alcohol dressing 20 (0,76) 415 (15,9) 1858 (71,3) 312 (11,9) 2605 (85,75) Lidocaine-based cream 0 (0) 20 (22,2) 58 (64,4) 12 (13,3) 90 (2,96) Cold pack 1 (1,25) 22 (27,5) 51 (63,7) 6 (7,5) 80 (2,63) Nonsteroidal anti-inflammatory cream 0 (0) 3 (15,7) 14 (73,7) 2 (10,5) 19 (0,63) Simple emollient 4 (3,6) 0 (0) 7 (63,6) 0 (0) 11 (0,36) Corticosteroid-based cream 0 (0) 0 (0) 4 (50) 4 (50) 8 (0,26) Other treatments 5 (3,2) 18 (11,5) 110 (70,1) 24 (15,3) 157 (5,17) No treatment 10 (14,7) 15 (22) 32 (47) 11 (16,2) 68 (2,24) Totals 40 (1,32) 493 (16,23) 2134 (70,24) 371 (12,21) 3038 (100) Numbers (n) and percentages (%) Out of the 3,038 participants who responded to the survey, 82.29% declared a satisfied or very satisfied opinion on the symptomatic treatments used for phlebitis on PVCs (83,3% for 70° alcohol dressing). Perceived satisfaction was not significantly different between different management strategies when a specific treatment was used. Using a specific treatment was perceived significantly more satisfying than no treatment (satisfied + very satisfied 83 vs 63% respectively, p < 0,0001). Discussion This practice survey highlights that the 70° alcohol dressing is the most used treatment by healthcare providers to treat phlebitis on PVCs. It is primarily used without a medical prescription, twice a day, until the symptoms (redness, swelling, pain, warmth) disappear, and it is satisfactory to the respondents. Many other modalities are used in this setting, and providing a specific treatment is perceived as more satisfying comparing with no treatment. The main strengths of this innovative practice survey are the significant sample size and the absence of a previously published national practice survey. Another strength is its broad coverage, which allowed for the interrogation of nurses practicing in various and diverse settings. Regarding the limitations of this study, the low response rate is attributed to its methodology. A bias of interest in the subject cannot be ruled out since not all professionals share the same level of interest in managing phlebitis related to PVCs. Recruitment bias is also a limitation because the survey only targeted certain regions in France registered with the National Order of Nurses (ONI), comprising 126,297 nurses out of the 504,000 registered in 2023. Since 2018, all nurses wishing to practice in France are required to register with the Order of Nurses in order to practice the nursing profession. This obligation applies to all modes of practice and is stipulated by Articles L. 4312-1 of the French Public Health Code. However, this survey managed to gather over 3,000 respondents involved in healthcare, providing a representative overview of nursing practices in symptomatic care for phlebitis in France. The survey questions did not allow for statistical correlations in the responses. It would have been interesting to evaluate, particularly, the hypothesis of a connection between the number of phlebitis cases encountered and the number of patients undergoing daily infusion therapy under the care of nurses. Indeed, one question inquired about the number of phlebitis cases observed in the department during the month preceding the survey, while another asked about the number of patients receiving infusion therapy in the department where the respondent worked on the day the questionnaire was completed. Regarding the treatment of phlebitis related to PVCs, the survey did not specify whether nurses had the same therapeutic strategy when other signs of complications were also present (examples: Abscess at the puncture site, fever). In the case of a medical complication, it would be interesting to know if caregivers would provide the same care without a medical prescription. 70° alcohol dressing was used by 85.75% of the respondents in the symptomatic treatment of phlebitis related to PVCs. However, there is no scientific evidence demonstrating the benefit of this management. Therefore, common practices are not based on evidence-based practice (EBP) [ 26 ], which contradicts the recommendations of good clinical practice. The management of phlebitis related to PVCs was mainly carried out without a medical prescription. However, theoretically, the most commonly used medications in our survey indeed require one in France as they are considered as medication (70° alcohol dressing, lidocaine-based cream, nonsteroidal anti-inflammatory cream, corticosteroid-based cream). One could question the necessity of a medical prescription in this context, given the expertise of nurses in the detection, monitoring, and management of this common complication, and even more so considering the excellent tolerance of the therapies applied. If we compare the treatments used by the respondents to a recent meta-analysis [ 12 ] regarding studies assessing the efficacy of topical treatments on symptoms of phlebitis related to PVCs, we notice that none of the treatments mentioned by the respondents appear in this meta-analysis. It would have been interesting, therefore, to inquire with the caregivers about the rationale behind their choice of symptomatic treatments used. Furthermore, the data collected on the effectiveness of the treatments used remain subjective as they are not scientifically verifiable and left to the nurses' discretion. Cold packs were the first non-pharmacological intervention that appeared in the survey results. The properties of cold therapy are already scientifically known to treat a local inflammatory process [ 27 , 28 ]. Furthermore, studies such as [ 29 – 31 ] highlight that the use of cold therapy on a painful area, or as a preventive measure for a painful procedure such as arterial puncture [ 32 ], has clear beneficial effects. However, to date, there is no scientific evidence regarding the benefits of cold packs in the treatment of phlebitis related to PVCs. Monitoring the symptoms of phlebitis related to PVCs is crucial for evaluating the benefits of treatment. Numerous surveillance scales are available to assist caregivers in assessing the severity of phlebitis symptoms [ 33 ]. However, in the survey responses, 98.39% of caregivers reported not using them. While no scale has been thoroughly validated for use in clinical practice, without tools to evaluate phlebitis related to PVCs, how can their occurrence and progression be assessed? An evaluation tool for phlebitis could be an additional tool in preventing phlebitis related to PVCs if recommendations regarding PVC insertion are followed. Conclusion This practice survey highlights that healthcare providers regularly encounter phlebitis on PVCs, and an heterogeneous management. Currently, with no specific guidelines in this situation, the choice is left to the healthcare providers. The beneficial effects of the treatments used have never been proven. Furthermore, the use of treatments without a medical prescription, such as the 70° alcohol dressing, is considered an act that is not within the scope of nurses’ competencies. Research efforts must now be undertaken to propose evidence-based management to the patient. It is necessary for studies to compare the effectiveness of commonly used treatments so that practice recommendations can be derived. Task delegation should also be recommended for the application of a 70° alcohol dressing or other topical treatment for phlebitis, as in practice, this is done in the vast majority of cases without a medical prescription. The cold pack is the first non-pharmacological intervention used by respondents, it is inexpensive and easy to use. It would be interesting to evaluate the effectiveness of this management. It would also be pertinent for research on an evaluation tool for phlebitis on PVCs to lead to scientific validation so that nurses can apply it uniformly and systematically in the case of PVC placement. This would allow for the quicker identification of potential symptoms of a phlebitis on PVCs to limit complications. Abbreviations PVC: Peripheral venous catheter PVCs: Peripheral venous catheters VIP: Visual Infusion Phlebitis EQUATOR: Enhancing the Quality and Transparency of Health Research GDPR: General Data Protection Regulation CNIL: Commission on Informatics and Liberty ERERC: Ethics Reflection Space of the Centre-Val de Loire Region EBP: Evidence-based practice ONI: National Order of Nurses Declarations Ethics approval and consent to participate Ethical opinion was sought from the Ethics Reflection Space of the Centre-Val de Loire Region (ERERC) regarding the use of the data collected from the survey. Favorable opinion was granted on October 10, 2023 for this project referenced under number 2023 042. Participants were provided with information about the research and its objectives, the confidentiality of their information, and their access to the study findings. Before accessing the questionnaire, and after being provided with information about the survey's context, objectives, and data anonymization, participants gave their informed consent. Participants who agreed to take part in the survey had to check the box stating, "I agree that the data provided in this survey will be used for research purposes." Only respondents who checked the box stating, "I agree that the data provided in this survey will be used for research purposes," could access the questionnaire. Thus, data anonymization and participant consent were upheld as required by the General Data Protection Regulation (GDPR) and the Declaration of Helsinki in the context of this study. Consent for publication Not applicable. Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare no competing interests. Funding This study had no funding support. Authors' contributions G.B.,A.L. conducted the investigation, G.B., A.D.V., A.L. performed data analysis, G.B. data curation, G.B., A.D.V., A.L. prepared Tables, G.B., A.D.V., A.L.,E.P., G.R. validation We certify that all named authors have contributed significantly to the work. All authors have carefully reviewed the manuscript and proposed significant modifications. Acknowledgements The authors would like to acknowledge for their support the University Hospital Center (CHRU) of Tours, the members of the Steering Committee of the Care Directorate of the CHRU of Tours, the Research and Innovation Directorate, the Clinical Research Strengthening Team of the CHRU of Tours, as well as the National Order of Nurses. The first author would like to thank Ms. GUINOISEAU Katty and Mr. THOMAS Guillaume for their support and guidance in drafting the article. References Parreira P, Sousa LB, Marques IA, Santos-Costa P, Braga LM, Cruz A, et al. Double-chamber syringe versus classic syringes for peripheral intravenous drug administration and catheter flushing: a study protocol for a randomised controlled trial. Trials. 2020;21(1):78. Guenezan J, Drugeon B, O’Neill R, Caillaud D, Sénamaud C, Pouzet C, et al. Skin antisepsis with chlorhexidine-alcohol versus povidone iodine-alcohol, combined or not with use of a bundle of new devices, for prevention of short-term peripheral venous catheter-related infectious complications and catheter failure: an open-label, single-centre, randomised, four-parallel group, two-by-two factorial trial: CLEAN 3 protocol study. BMJ Open. 2019;9(4):e028549. Wallis MC, McGrail M, Webster J, Marsh N, Gowardman J, Playford EG, et al. Risk Factors for Peripheral Intravenous Catheter Failure: A Multivariate Analysis of Data from a Randomized Controlled Trial. Infect Control Hosp Epidemiol. 2014;35(1):63‑8. Guanche-Sicilia A, Sánchez-Gómez MB, Castro-Peraza ME, Rodríguez-Gómez JÁ, Gómez-Salgado J, Duarte-Clíments G. Prevention and Treatment of Phlebitis Secondary to the Insertion of a Peripheral Venous Catheter: A Scoping Review from a Nursing Perspective. Healthc Basel Switz. 2021;9(5):611. Grüne F, Schrappe M, Basten J, Wenchel HM, Tual E, Stützer H, et al. Phlebitis rate and time kinetics of short peripheral intravenous catheters. Infection. 2004;32(1):30‑2. Marsh N, Webster J, Ullman AJ, Mihala G, Cooke M, Chopra V, et al. Peripheral intravenous catheter non-infectious complications in adults: A systematic review and meta-analysis. J Adv Nurs. 2020;76(12):3346‑62. Abdul-Hak CK, Barros ÂF. The incidence of phlebitis in a Medical Clinical Unit. Texto Contexto - Enferm. 2014;23(3):633‑8. Capdevila-Reniu A, Capdevila JA. Peripheral venous catheter, a dangerous weapon. Key points to improve its use. Rev Clin Esp. 2017;217(8):464‑7. Braga LM, Parreira PM, Oliveira A de SS, Mónico LDSM, Arreguy-Sena C, Henriques MA. Phlebitis and infiltration: vascular trauma associated with the peripheral venous catheter. Rev Lat Am Enfermagem. 2018;26:e3002. Goulart CB, Custódio CS, Vasques CI, Ferreira EB, Diniz Dos Reis PE. Effectiveness of topical interventions to prevent or treat intravenous therapy-related phlebitis: A systematic review. J Clin Nurs. 2020;29(13‑14):2138‑49. Atay S, Sen S, Cukurlu D. Phlebitis-related peripheral venous catheterization and the associated risk factors. Niger J Clin Pract. 2018;21(7):827‑31. Garcia-Expósito J, Sánchez-Meca J, Almenta-Saavedra JA, Llubes-Arrià L, Torné-Ruiz A, Roca J. Peripheral venous catheter-related phlebitis: A meta-analysis of topical treatment. Nurs Open. 2023;10(3):1270‑80. Nickel B. Peripheral Intravenous Access: Applying Infusion Therapy Standards of Practice to Improve Patient Safety. Crit Care Nurse. 2019;39(1):61‑71. Lv L, Zhang J. The incidence and risk of infusion phlebitis with peripheral intravenous catheters: A meta-analysis. J Vasc Access. 2020;21(3):342‑9. Cicolini G, Bonghi AP, Di Labio L, Di Mascio R. Position of peripheral venous cannulae and the incidence of thrombophlebitis: an observational study. J Adv Nurs. 2009;65(6):1268‑73. Couzigou C, Lamory J, Salmon-Ceron D, Figard J, Vidal-Trecan GM. Short peripheral venous catheters: effect of evidence-based guidelines on insertion, maintenance and outcomes in a university hospital. J Hosp Infect. 2005;59(3):197‑204. Capdevila JA, Guembe M, Barberán J, de Alarcón A, Bouza E, Fariñas MC, et al. 2016 Expert consensus document on prevention, diagnosis and treatment of short-term peripheral venous catheter-related infections in adult. Rev Espanola Quimioter Publicacion Of Soc Espanola Quimioter. 2016;29(4):230‑8. Loveday HP, Wilson JA, Pratt RJ, Golsorkhi M, Tingle A, Bak A, et al. epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. J Hosp Infect. 2014;86 Suppl 1:S1-70. Alexandrou E, Ray‐Barruel G, Carr PJ, Frost SA, Inwood S, Higgins N, et al. Use of Short Peripheral Intravenous Catheters: Characteristics, Management, and Outcomes Worldwide. J Hosp Med. 2018;13(5):E1-7. https://shmpublications.onlinelibrary.wiley.com/doi/10.12788/jhm.3039 Zheng GH, Yang L, Chen HY, Chu JF, Mei L. Aloe vera for prevention and treatment of infusion phlebitis. Cochrane Database Syst Rev. 2014;2014(6):CD009162. Ravindra H, Patel KD. A quasi experimental study to evaluate effectiveness of glycerin magnesium sulphate dressing on phlebitis among patients undergoing peripheral intravenous infusion in selected hospital, Vadodara. Int J Med Res Health Sci. 2015;4(3):527. Tzolos E, Salawu A. Improving the frequency of visual infusion phlebitis (VIP) scoring on an oncology ward. BMJ Qual Improv Rep. 2014;3(1):u205455.w2364. Gallant P, Schultz AA. Evaluation of a visual infusion phlebitis scale for determining appropriate discontinuation of peripheral intravenous catheters. J Infus Nurs Off Publ Infus Nurses Soc. 2006;29(6):338‑45. Simera I, Moher D, Hoey J, Schulz KF, Altman DG. The EQUATOR Network and reporting guidelines: Helping to achieve high standards in reporting health research studies. Maturitas. 2009;63(1):4‑6. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344‑9. Brunt BA, Morris MM. Nursing Professional Development Evidence-Based Practice. In: StatPearls [Internet]. StatPearls Publishing; 2024 [cité 20 févr 2024]. Disponible sur: http://www.ncbi.nlm.nih.gov/books/NBK589676/ Herrera E, Sandoval MC, Camargo DM, Salvini TF. Motor and Sensory Nerve Conduction Are Affected Differently by Ice Pack, Ice Massage, and Cold Water Immersion. Phys Ther. 2010;90(4):581‑91. Nadler SF, Weingand K, Kruse RJ. The physiologic basis and clinical applications of cryotherapy and thermotherapy for the pain practitioner. Pain Physician. 2004;7(3):395‑9. Aghajanloo A, Ghafourifard M, Haririan H, Gheydari P. Comparison of the effects of cryotherapy and placebo on reducing the pain of arteriovenous fistula cannulation among hemodialysis patients: A randomized control trial. J Nurs Midwifery Sci. 2016;3(1):59. Shin J, Kim GS, Sim H. Comparing the effectiveness of three pain relief methods for inserting a needle into the implanted venous access chemoport: A randomized controlled trial. Int J Nurs Pract. 2022;28(4):e12974. Watkins AA, Johnson TV, Shrewsberry AB, Nourparvar P, Madni T, Watkins CJ, et al. Ice Packs Reduce Postoperative Midline Incision Pain and Narcotic Use: A Randomized Controlled Trial. J Am Coll Surg. 2014;219(3):511‑7. Bastami M. The Use of Ice Pack for Pain Associated with Arterial Punctures. J Clin Diagn Res. 2015;9(8):JC07-9 Ray‐Barruel G, Polit DF, Murfield JE, Rickard CM. Infusion phlebitis assessment measures: a systematic review. J Eval Clin Pract. 2014;20(2):191‑202. Additional Declarations No competing interests reported. Supplementary Files Additionalfile1.docx Additionalfile2.docx Additionalfile3.docx Additionalfile4.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4598400","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":327222016,"identity":"ecc57744-e697-4196-9b93-6ff8aec92773","order_by":0,"name":"Guillaume BROUILLET","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA90lEQVRIiWNgGAWjYFACHhAhIcPHwMD4gLEBLixHUAsPGwMzswFICw9E2JiQFgaQFjYJorTIO/Ae+/CxzYKHjb3/WMXPHYcZ7Nl7zD7+YDDIx6XF8ABf8syZbUCH8Rxmu9l75jADD88Z49k8DAaWDbi0NPAYM/OCtEgks91mbDtc3yORY8zMwPDHAKctcC3yj9mKgVoYeIBaGIEOw6lFngFuCzMbM0wLMAxwazFg5ktmnHEO5JdkY8netnQGnjPHipl5DPDY0t57mOFDWZ0cP/vBhx9+tlkzsLc3b2b8UYHHlsM4xHFpANrSgFtuFIyCUTAKRgEEAABzrj/IGvuyzgAAAABJRU5ErkJggg==","orcid":"","institution":"Infectious Diseases Department, University Hospital of Tours, Tours, France","correspondingAuthor":true,"prefix":"","firstName":"Guillaume","middleName":"","lastName":"BROUILLET","suffix":""},{"id":327222017,"identity":"9f3a49d7-070b-48b7-b84c-aaa8ba1f5f14","order_by":1,"name":"Axel DI VITTORIO","email":"","orcid":"","institution":"Department of Physical Medicine and Rehabilitation, University Hospital Center of Tours","correspondingAuthor":false,"prefix":"","firstName":"Axel","middleName":"DI","lastName":"VITTORIO","suffix":""},{"id":327222018,"identity":"ed99e2d9-64fe-4f71-af0a-0310e915d110","order_by":2,"name":"Elisabeth PINSON","email":"","orcid":"","institution":"Operational hygiene team, Hygiene specialist, University Hospital of Tours","correspondingAuthor":false,"prefix":"","firstName":"Elisabeth","middleName":"","lastName":"PINSON","suffix":""},{"id":327222019,"identity":"0470c8b6-f4e0-4441-bef2-1063516032db","order_by":3,"name":"Geoffroy ROUSSEAU","email":"","orcid":"","institution":"Emergency Medicine Department, University Hospital of Tours","correspondingAuthor":false,"prefix":"","firstName":"Geoffroy","middleName":"","lastName":"ROUSSEAU","suffix":""},{"id":327222020,"identity":"a4f8a10d-f511-44f7-892a-935172ff6288","order_by":4,"name":"Adrien LEMAIGNEN","email":"","orcid":"","institution":"Infectious Diseases Department, University Hospital of Tours, Tours, France","correspondingAuthor":false,"prefix":"","firstName":"Adrien","middleName":"","lastName":"LEMAIGNEN","suffix":""}],"badges":[],"createdAt":"2024-06-18 08:14:16","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4598400/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4598400/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":60816738,"identity":"181ac0c8-1a76-4df1-8aa8-3a511b603374","added_by":"auto","created_at":"2024-07-22 12:05:37","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":830007,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4598400/v1/cbba6298-0806-4a3f-abf4-b173b988d136.pdf"},{"id":60567355,"identity":"1e64d7fc-fd09-4afe-9e02-c2ab7644e83d","added_by":"auto","created_at":"2024-07-18 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08:58:42","extension":"docx","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":14217,"visible":true,"origin":"","legend":"","description":"","filename":"Additionalfile3.docx","url":"https://assets-eu.researchsquare.com/files/rs-4598400/v1/a0b005a4d8d9354bf4543e34.docx"},{"id":60566920,"identity":"2d566714-e6b3-4870-a80f-6c2411d8200c","added_by":"auto","created_at":"2024-07-18 08:42:42","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":14631,"visible":true,"origin":"","legend":"","description":"","filename":"Additionalfile4.docx","url":"https://assets-eu.researchsquare.com/files/rs-4598400/v1/77f5189434b0afbd7096f481.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Symptomatic Management of phlebitis on peripheral venous catheters: A national survey of nursing practice.","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe insertion of a peripheral venous catheter (PVC) is one of the most commonly performed procedures by nurses in the hospital setting [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. In the United States alone, 330\u0026nbsp;million peripheral venous catheters (PVCs) are used annually [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e], and globally, this number is estimated to exceed 2\u0026nbsp;billion. This type of equipment is used to facilitate the administration of medical products that cannot be given orally, including hydroelectrolytic balance, medications, and nutrition [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Several complications are possible, including catheter obstruction, extravasation, thrombosis, hematoma at the puncture site, and phlebitis [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThese events may require local care, the administration of specific treatments, and can cause significant discomfort for the patient, prolonged hospitalization, and even lead to serious infectious complications such as bacteremia, especially in the case of phlebitis [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePhlebitis on a PVC is an inflammation of the inner wall of a vein called the \"intima\" developed in response to tissue damage caused by factors associated with the insertion and use of the PVC and the medications administered through it [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. The intima is primarily composed of endothelial cells, which, when injured or irritated, trigger the release of histamines, bradykinin, and serotonin. This leads to a painful response and dilates the vein, causing swelling and sensitivity [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Phlebitis can be classified into 3 categories: mechanical, when the phlebitis is related to the action of the PVC on the vein; chemical, when it is related to medications; and bacterial, when it is related to contamination at the insertion site, intravenous solution, or tubing [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eStudies measuring the rate of phlebitis on PVCs present heterogeneous results. The use of different outcome criteria in these studies may explain this disparity, with an incidence of phlebitis on PVCs ranging from 6 to 70% according to the studies [\u003cspan additionalcitationids=\"CR12\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. The classic risk factors associated are insufficient asepsia during insertion, prolonged duration of PVC placement, and inadequate local monitoring [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Other factors can also increase the risk of phlebitis on PVCs, such as the catheter insertion site, catheter size, as well as the advanced age of infused patients [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. To prevent phlebitis on PVCs, international guidelines advocate for limiting the indications for PVC insertion, ensuring strict asepsia before catheter placement, selecting the appropriate antiseptic (alcoholic antiseptic), limiting the duration of PVC placement, and closely monitoring skin condition through transparent dressings, among others [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eCurrently, while it is recommended to remove the PVC upon detection of phlebitis [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e], there are no specific guidelines for the symptomatic management of phlebitis on PVCs. Therapeutic options often vary depending on the centers or individuals, with the use of various treatments with a low level of evidence, such as Aloe Vera [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e], sesame oil [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], and glycerin magnesium sulphate dressing [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Nurses, who are responsible for inserting, maintaining, and monitoring PVCs, also play a role in restoring patients' health [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eCurrently, there are several scales available to identify signs of phlebitis on PVCs and monitor its progression, such as the Visual Infusion Phlebitis (VIP) [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] scale and the MADDOX scale [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eTo our knowledge, there is any literature surveying nursing practices describing the habits of healthcare providers in treating this common complication.\u003c/p\u003e \u003cp\u003eOur study therefore aimed primarily to identify the treatments used by healthcare providers in France in managing phlebitis on PVCs.We had three secondary objectives in this survey: 1/ to determine whether the treatments used in this complication were applied with or without a medical prescription; 2/ to understand the modalities of use of treatments applied for phlebitis on PVCs; and 3/ to evaluate the satisfaction of healthcare providers with the effectiveness provided by the treatments used in this complication.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eStudy design\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eTo gather a large amount of data directly from the field over a short period, we chose to conduct a national practice survey.\u003c/p\u003e \u003cp\u003eTo establish current nursing practices in France regarding the symptomatic treatment of phlebitis, we initially searched the Enhancing the Quality and Transparency of Health Research (EQUATOR) network [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e], for guidelines on conducting a practice survey. Within the framework of this observational study, the STROBE checklist (See Additional file 1) [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e] was followed.\u003c/p\u003e \u003cp\u003eTherefore, we conducted this practice survey using a standardized online questionnaire via the website: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.lesphinx-developpement.fr/\u003c/span\u003e\u003cspan address=\"https://www.lesphinx-developpement.fr/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/p\u003e \u003cp\u003eThe questionnaire was developed multidisciplinary (nurse, physician, nurse executive) and was tested on a sample of nurses within the hospital where the survey was developed before its national distribution. Following feedback from the nurses who tested the survey and considering their remarks on sometimes ambiguous question formulations, we finalized our questionnaire ready for national distribution.\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eSurvey tool\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eThe final version of the questionnaire included an introduction explaining the context of phlebitis on peripheral venous catheters and the objectives of the survey. Responses to the questionnaire were anonymous, and respondents were asked to provide their express consent by checking a box before filling out the questionnaire (See Additional file 2).\u003c/p\u003e \u003cp\u003eThe first three questions focused on the respondent's role, the type of facility, and the specialty in which they worked.\u003c/p\u003e \u003cp\u003eThe second part of the questionnaire was based on epidemiological data, with four questions regarding the number of patients cared for by the respondent, the number of patients receiving infusions, and the number of phlebitis cases observed in the month preceding the questionnaire. A third part of the questionnaire listed the treatments used for phlebitis on peripheral venous catheters with eight questions for this purpose. The first-line treatment used for phlebitis on PVCs, the modalities of treatment use, the presence of a medical prescription or not, the use of a scale to evaluate phlebitis symptoms, and the assessment of the effectiveness of the treatment used were asked.\u003c/p\u003e \u003cp\u003eThe survey comprised mandatory response questions except for the one asking for the number of beds available in the respondent's department or where the healthcare professional works. Indeed, caregivers with cross-cutting missions may work in several departments on the same day and work in others on another day. Therefore, it was not possible for them to specify the number of beds for each department.\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eEthical Considerations\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eThe questionnaire was submitted to the General Data Protection Regulation (GDPR). Since the data of the participants collected were anonymized, it was not possible to trace their identity. Therefore, no agreement from the National Commission on Informatics and Liberty (CNIL) was necessary for the realization of this survey.\u003c/p\u003e \u003cp\u003e Ethical opinion was sought from the Ethics Reflection Space of the Centre-Val de Loire Region (ERERC) regarding the use of the data collected from the survey. Favorable opinion was granted on October 10, 2023 for this project referenced under number 2023 042.\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eSample\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eThis practice survey was aimed at registered nurses with a state diploma registered with the National Order of Nurses (ONI) in France, to obtain precise and objective responses on a recurring complication for which they are responsible for monitoring.\u003c/p\u003e \u003cp\u003eThe Presidents of the Regional Councils of the ONI were contacted by email to send our practice survey to the members registered in their respective regions. The survey was thus distributed via email with the agreements of the presidents of the Centre-Val de Loire, Nouvelle-Aquitaine, Auvergne-Rh\u0026ocirc;ne-Alpes regions, and in the Overseas Departments (La R\u0026eacute;union and Mayotte). It was possible to respond to the survey from March 31, 2023, to April 30, 2023. No email reminders were sent.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e\u0026bull; Data Analysis\u003c/h2\u003e \u003cp\u003eThe anonymized data collected on the website \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.lesphinx-developpement.fr/\u003c/span\u003e\u003cspan address=\"https://www.lesphinx-developpement.fr/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e were extracted and converted into an Excel file (2010 version) for analysis.\u003c/p\u003e \u003cp\u003eThe responses to the survey questions were described using frequencies and percentages for qualitative variables.\u003c/p\u003e \u003cp\u003e We compared satisfaction level according treatment using a Chi-square test for hypothesis testing, the \"p\" value indicated a significant difference if it was \u0026le;\u0026thinsp;0.05.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eIn total, the questionnaire was sent to 126,297 nurses. Among them, we received 3,038 responses, representing a response rate of 2.41%.\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003ePopulation Characteristics\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eRegistered nurses with the ONI can work in various settings, different departments, and may have progressed into roles such as nurse executive, hygiene referent, or others (Operating room nurses, nurse anesthetist, advanced practice nurse, pediatric nurse, nurse educator, manager of a Medico-Social Facility).\u003c/p\u003e \u003cp\u003eAmong the facilities where caregivers responded most to this survey, we mainly find those working in medicine services (29.26%) and surgery services (13.53%) (See Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDistribution of caregivers according to their practice settings\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eProfessions\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eStructures\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTotals\u003c/p\u003e \u003cp\u003eby professions,\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHospital center,\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePrivate practice,\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUniversity hospital center,\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eOther healthcare or medical-social structures,\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ePrivate clinic,\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNurse\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e832 (27.39)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e743 (24.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e502 (16.52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e430 (14.15)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e363 (11.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2870 (94.47)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNurse executive\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24 (0.79)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (0.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6 (0.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e30 (0.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e16 (0.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e77 (2.53)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHygiene referent\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24 (0.79)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (0.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8 (0.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e20 (0.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e7 (0.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e61 (2.01)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOther\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11 (0.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11 (0.36)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6 (0.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2 (0.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e30 (0.99)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotals by\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003estructures\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e891 (29.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e746 (24.56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e527 (17.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e486 (16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e388 (12.77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3038 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eNumbers (n) and percentages (%)\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eReported frequency of phlebitis on peripheral venous catheters\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003e(See Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e and Additional file 3) Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e highlights that 1677 (55.20%) of respondents reported observing at least one phlebitis in the month preceding the survey.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDistribution of the number of reported phlebitis on PVCs by respondents\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eNumber of reported phlebitis on PVCs\u003c/p\u003e \u003cp\u003eby respondents\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003eSpecialties of respondents\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTotal,\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eMedicine\u003c/b\u003e,\u003c/p\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eSurgery\u003c/b\u003e,\u003c/p\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003ePrivate Practice\u003c/b\u003e,\u003c/p\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eEmergency\u003c/b\u003e,\u003c/p\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e*Other\u003c/b\u003e,\u003c/p\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e0\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e165 (5.43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e80 (2.63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e603 (19.85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e74 (2.44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e439 (14.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1361 (44.80)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e1\u0026ndash;5\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e555 (18.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e268 (8.82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e135 (4.44)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e75 (2.47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e350 (11.52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1383 (45.52)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e6\u0026ndash;10\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e124 (4.08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50 (1.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1 (0.03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e15 (0.49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e28 (0.92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e218 (7.18)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e\u0026gt;\u0026thinsp;10\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e45 (1.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13 (0.43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3 (0.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5 (0.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e10 (0.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e76 (2.50)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e**Total respondents\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e889 (29.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e411 (13.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e742 (24.42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e169 (5.56)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e827 (27.22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3038 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eNumbers (n) and percentages (%)\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e*The \"other\" column in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e groups together 19 specialties (Additional file 3), such as respondents working in intensive care units, in correctional facilities, in rehabilitation centers, etc.\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e**The total respondents correspond to the number of respondents per specialty who observed phlebitis on PVCs in the month preceding the survey.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eMedicine services are the specialty where respondents reported the most phlebitis on PVCs in the month preceding the survey.\u003c/p\u003e \u003cp\u003eThe specialty of medicine had the highest number of patients on infusion therapy on the day respondents answered the questionnaire, with a total of 10,473 patients, followed by surgical services with 6,351 patients on infusion therapy. Emergency departments followed with 4,961 patients on infusion therapy, and 949 patients received care in outpatient settings. Other specialties accounted for 6,820 patients on infusion therapy.\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eSymptomatic treatments for phlebitis related to peripheral venous catheters:\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eVarious treatments were utilized among the survey respondents in managing phlebitis related to PVCs apart from catheter removal. (See Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e) Six treatments were the most frequently mentioned by respondents. Among other treatments applied, 33 different management approaches were described (Additional file 4), primarily involving the use of 30% glucose compress and glycerin alcohol. Some also reported not using any treatment for this complication.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eList of treatments used by respondents for symptomatic management of phlebitis besides removing the implicated catheter\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTreatments used\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eMedical prescription\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTotal,\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eNon-prescription care\u003c/b\u003e,\u003c/p\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003ePrescription-based care\u003c/b\u003e,\u003c/p\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e70\u0026deg; alcohol dressing\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2407 (79.23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e198 (6.52)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2605 (85.75)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLidocaine-based cream\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e76 (2.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14 (0.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e90 (2.96)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCold pack\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e71 (2.34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9 (0.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e80 (2.63)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNonsteroidal anti-inflammatory cream\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e16 (0.53)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (0.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19 (0.63)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSimple emollient\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8 (0.26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3 (0.10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11 (0.36)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCorticosteroid-based cream\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2 (0.07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6 (0.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8 (0.26)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOther treatments\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e125 (4.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32 (1.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e157 (5.17)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNo treatment\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e49 (1.61)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19 (0.63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e68 (2.24)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotals\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2754 (90.65)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e284 (9.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3038 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eNumbers (n) and percentages (%)\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eResults presented in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e also highlight the use of a medical prescription or not in the treatments used by survey respondents for phlebitis on PVCs. The 70\u0026deg; alcohol dressing was the most commonly used treatment by respondents, and was used without a medical prescription in more than 90% of cases. Generally, for the six most cited treatments, 91.72% of respondents declared not using a medical prescription.\u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003eModalities of symptomatic treatments applied for phlebitis\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003eThe duration of symptomatic treatment for phlebitis on PVCs varied. Indeed, although using the same treatment, healthcare providers applied it for either 1 to 7 days or continue until the symptoms disappearance (redness, warmth, swelling, pain), with 60.46% of them not specifying the exact number of days. Treatment was administered twice a day for 39.43% of respondents (See Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDaily utilization methods of treatments in the management of phlebitis on PVCs\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTreatments Used\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003eNumber of applications per day\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTotal,\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eOnce daily\u003c/b\u003e,\u003c/p\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eTwice daily\u003c/b\u003e,\u003c/p\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eThree times daily\u003c/b\u003e,\u003c/p\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eFour times daily\u003c/b\u003e,\u003c/p\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003eAs needed by the patient\u003c/b\u003e,\u003c/p\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e70\u0026deg; alcohol dressing\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e402 (15,43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1039 (39,88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e569 (21,84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e137 (5,26)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e458 (17,58)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2605 (87,71)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLidocaine-based cream\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e24 (0,81)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e36 (1,21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11 (0,37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2 (0,07)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e17 (0,57)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e90 (3,03)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCold pack\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6 (0,20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (0,84)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11 (0,37)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6 (0,20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e32 (1,08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e80 (2,69)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNonsteroidal anti-inflammatory cream\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (0,03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (0,34)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (0,13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4 (0,13)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e19 (0,64)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSimple emollient\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (0,03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (0,03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3 (0,10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1 (0,03)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5 (0,17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e11 (0,37)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCorticosteroid-based cream\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3 (0,10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (0,17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8 (0,27)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOther treatments\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e33 (1,11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55 (1,85)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35 (1,18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5 (0,17)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e29 (0,98)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e157 (5,29)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotals*\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e470 (15,82)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1171 (39,43)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e633 (21,31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e151 (5,08)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e545 (18,35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2970 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eNumbers (n) and percentages (%)\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003e*Totals calculated only with respondents using symptomatic treatment for phlebitis on PVCs (those not using any treatment were not included in the table)\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003ePerception of treatment effectiveness by healthcare providers\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003e(See Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e) Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e describes the satisfaction of healthcare providers about the treatment effectiveness according to management strategy. Considering the evaluation of management effectiveness, 98.39% of respondents reported not using a standardized scale to evaluate phlebitis (example: The Visual Infusion Phlebitis scale) (22).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSatisfaction of healthcare providers in the effectiveness of treatments used for phlebitis on PVCs\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTreatments Used\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c5\" namest=\"c2\"\u003e \u003cp\u003eSatisfaction\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTotal,\u003c/p\u003e \u003cp\u003en (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eNot satisfied at all\u003c/b\u003e,\u003c/p\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003eSlightly satisfied\u003c/b\u003e,\u003c/p\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003eSatisfied\u003c/b\u003e,\u003c/p\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003eVery satisfied\u003c/b\u003e,\u003c/p\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003e70\u0026deg; alcohol dressing\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20 (0,76)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e415 (15,9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1858 (71,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e312 (11,9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2605 (85,75)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eLidocaine-based cream\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20 (22,2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e58 (64,4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12 (13,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e90 (2,96)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCold pack\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1 (1,25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22 (27,5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51 (63,7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6 (7,5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e80 (2,63)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNonsteroidal anti-inflammatory cream\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3 (15,7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14 (73,7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2 (10,5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e19 (0,63)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSimple emollient\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4 (3,6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7 (63,6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11 (0,36)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCorticosteroid-based cream\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0 (0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4 (50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4 (50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8 (0,26)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOther treatments\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5 (3,2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18 (11,5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e110 (70,1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e24 (15,3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e157 (5,17)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNo treatment\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10 (14,7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15 (22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32 (47)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11 (16,2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e68 (2,24)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotals\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40 (1,32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e493 (16,23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2134 (70,24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e371 (12,21)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3038 (100)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003eNumbers (n) and percentages (%)\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e Out of the 3,038 participants who responded to the survey, 82.29% declared a satisfied or very satisfied opinion on the symptomatic treatments used for phlebitis on PVCs (83,3% for 70\u0026deg; alcohol dressing). Perceived satisfaction was not significantly different between different management strategies when a specific treatment was used. Using a specific treatment was perceived significantly more satisfying than no treatment (satisfied\u0026thinsp;+\u0026thinsp;very satisfied 83 vs 63% respectively, p\u0026thinsp;\u0026lt;\u0026thinsp;0,0001).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis practice survey highlights that the 70\u0026deg; alcohol dressing is the most used treatment by healthcare providers to treat phlebitis on PVCs. It is primarily used without a medical prescription, twice a day, until the symptoms (redness, swelling, pain, warmth) disappear, and it is satisfactory to the respondents. Many other modalities are used in this setting, and providing a specific treatment is perceived as more satisfying comparing with no treatment.\u003c/p\u003e \u003cp\u003eThe main strengths of this innovative practice survey are the significant sample size and the absence of a previously published national practice survey.\u003c/p\u003e \u003cp\u003eAnother strength is its broad coverage, which allowed for the interrogation of nurses practicing in various and diverse settings.\u003c/p\u003e \u003cp\u003eRegarding the limitations of this study, the low response rate is attributed to its methodology. A bias of interest in the subject cannot be ruled out since not all professionals share the same level of interest in managing phlebitis related to PVCs. Recruitment bias is also a limitation because the survey only targeted certain regions in France registered with the National Order of Nurses (ONI), comprising 126,297 nurses out of the 504,000 registered in 2023.\u003c/p\u003e \u003cp\u003eSince 2018, all nurses wishing to practice in France are required to register with the Order of Nurses in order to practice the nursing profession. This obligation applies to all modes of practice and is stipulated by Articles L. 4312-1 of the French Public Health Code. However, this survey managed to gather over 3,000 respondents involved in healthcare, providing a representative overview of nursing practices in symptomatic care for phlebitis in France.\u003c/p\u003e \u003cp\u003eThe survey questions did not allow for statistical correlations in the responses. It would have been interesting to evaluate, particularly, the hypothesis of a connection between the number of phlebitis cases encountered and the number of patients undergoing daily infusion therapy under the care of nurses. Indeed, one question inquired about the number of phlebitis cases observed in the department during the month preceding the survey, while another asked about the number of patients receiving infusion therapy in the department where the respondent worked on the day the questionnaire was completed.\u003c/p\u003e \u003cp\u003eRegarding the treatment of phlebitis related to PVCs, the survey did not specify whether nurses had the same therapeutic strategy when other signs of complications were also present (examples: Abscess at the puncture site, fever). In the case of a medical complication, it would be interesting to know if caregivers would provide the same care without a medical prescription.\u003c/p\u003e \u003cp\u003e70\u0026deg; alcohol dressing was used by 85.75% of the respondents in the symptomatic treatment of phlebitis related to PVCs. However, there is no scientific evidence demonstrating the benefit of this management. Therefore, common practices are not based on evidence-based practice (EBP) [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e], which contradicts the recommendations of good clinical practice.\u003c/p\u003e \u003cp\u003eThe management of phlebitis related to PVCs was mainly carried out without a medical prescription. However, theoretically, the most commonly used medications in our survey indeed require one in France as they are considered as medication (70\u0026deg; alcohol dressing, lidocaine-based cream, nonsteroidal anti-inflammatory cream, corticosteroid-based cream). One could question the necessity of a medical prescription in this context, given the expertise of nurses in the detection, monitoring, and management of this common complication, and even more so considering the excellent tolerance of the therapies applied.\u003c/p\u003e \u003cp\u003eIf we compare the treatments used by the respondents to a recent meta-analysis [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] regarding studies assessing the efficacy of topical treatments on symptoms of phlebitis related to PVCs, we notice that none of the treatments mentioned by the respondents appear in this meta-analysis. It would have been interesting, therefore, to inquire with the caregivers about the rationale behind their choice of symptomatic treatments used.\u003c/p\u003e \u003cp\u003eFurthermore, the data collected on the effectiveness of the treatments used remain subjective as they are not scientifically verifiable and left to the nurses' discretion.\u003c/p\u003e \u003cp\u003eCold packs were the first non-pharmacological intervention that appeared in the survey results. The properties of cold therapy are already scientifically known to treat a local inflammatory process [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Furthermore, studies such as [\u003cspan additionalcitationids=\"CR30\" citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e] highlight that the use of cold therapy on a painful area, or as a preventive measure for a painful procedure such as arterial puncture [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e], has clear beneficial effects. However, to date, there is no scientific evidence regarding the benefits of cold packs in the treatment of phlebitis related to PVCs.\u003c/p\u003e \u003cp\u003eMonitoring the symptoms of phlebitis related to PVCs is crucial for evaluating the benefits of treatment. Numerous surveillance scales are available to assist caregivers in assessing the severity of phlebitis symptoms [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. However, in the survey responses, 98.39% of caregivers reported not using them. While no scale has been thoroughly validated for use in clinical practice, without tools to evaluate phlebitis related to PVCs, how can their occurrence and progression be assessed? An evaluation tool for phlebitis could be an additional tool in preventing phlebitis related to PVCs if recommendations regarding PVC insertion are followed.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis practice survey highlights that healthcare providers regularly encounter phlebitis on PVCs, and an heterogeneous management. Currently, with no specific guidelines in this situation, the choice is left to the healthcare providers. The beneficial effects of the treatments used have never been proven. Furthermore, the use of treatments without a medical prescription, such as the 70\u0026deg; alcohol dressing, is considered an act that is not within the scope of nurses\u0026rsquo; competencies.\u003c/p\u003e \u003cp\u003eResearch efforts must now be undertaken to propose evidence-based management to the patient. It is necessary for studies to compare the effectiveness of commonly used treatments so that practice recommendations can be derived.\u003c/p\u003e \u003cp\u003eTask delegation should also be recommended for the application of a 70\u0026deg; alcohol dressing or other topical treatment for phlebitis, as in practice, this is done in the vast majority of cases without a medical prescription.\u003c/p\u003e \u003cp\u003eThe cold pack is the first non-pharmacological intervention used by respondents, it is inexpensive and easy to use. It would be interesting to evaluate the effectiveness of this management.\u003c/p\u003e \u003cp\u003eIt would also be pertinent for research on an evaluation tool for phlebitis on PVCs to lead to scientific validation so that nurses can apply it uniformly and systematically in the case of PVC placement. This would allow for the quicker identification of potential symptoms of a phlebitis on PVCs to limit complications.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003ePVC:\u003c/em\u003e\u003c/strong\u003e Peripheral venous catheter\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003ePVCs:\u003c/em\u003e\u003c/strong\u003e Peripheral venous catheters\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eVIP:\u003c/em\u003e\u003c/strong\u003e Visual Infusion Phlebitis\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eEQUATOR:\u003c/em\u003e\u003c/strong\u003e Enhancing the Quality and Transparency of Health Research\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eGDPR:\u003c/em\u003e\u003c/strong\u003e General Data Protection Regulation\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eCNIL:\u003c/em\u003e\u003c/strong\u003e Commission on Informatics and Liberty\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eERERC:\u003c/em\u003e\u003c/strong\u003e Ethics Reflection Space of the Centre-Val de Loire Region\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eEBP:\u003c/em\u003e\u003c/strong\u003e Evidence-based practice\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eONI:\u003c/em\u003e\u003c/strong\u003e National Order of Nurses\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent to participate\u003c/p\u003e\n\u003cp\u003eEthical opinion was sought from the Ethics Reflection Space of the Centre-Val de Loire Region (ERERC) regarding the use of the data collected from the survey. Favorable opinion was granted on October 10, 2023 for this project referenced under number 2023 042. Participants were provided with information about the research and its objectives, the confidentiality of their information, and their access to the study findings. Before accessing the questionnaire, and after being provided with information about the survey\u0026apos;s context, objectives, and data anonymization, participants gave their informed consent. Participants who agreed to take part in the survey had to check the box stating, \u0026quot;I agree that the data provided in this survey will be used for research purposes.\u0026quot;\u003c/p\u003e\n\u003cp\u003eOnly respondents who checked the box stating, \u0026quot;I agree that the data provided in this survey will be used for research purposes,\u0026quot; could access the questionnaire.\u003c/p\u003e\n\u003cp\u003eThus, data anonymization and participant consent were upheld as required by the General Data Protection Regulation (GDPR) and the Declaration of Helsinki in the context of this study.\u003c/p\u003e\n\u003cp\u003eConsent for publication\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003eAvailability of data and materials\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003eCompeting interests\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003eFunding\u003c/p\u003e\n\u003cp\u003eThis study had no funding support.\u003c/p\u003e\n\u003cp\u003eAuthors\u0026apos; contributions\u003c/p\u003e\n\u003cp\u003eG.B.,A.L. conducted the investigation,\u003c/p\u003e\n\u003cp\u003eG.B., A.D.V., A.L. performed data analysis,\u003c/p\u003e\n\u003cp\u003eG.B. data curation,\u003c/p\u003e\n\u003cp\u003eG.B., A.D.V., A.L. prepared Tables,\u003c/p\u003e\n\u003cp\u003eG.B., A.D.V., A.L.,E.P., G.R. validation\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWe certify that all named authors have contributed significantly to the work. All authors have carefully reviewed the manuscript and proposed significant modifications.\u003c/p\u003e\n\u003cp\u003eAcknowledgements\u003c/p\u003e\n\u003cp\u003eThe authors would like to acknowledge for their support the University Hospital Center (CHRU) of Tours, the members of the Steering Committee of the Care Directorate of the CHRU of Tours, the Research and Innovation Directorate, the Clinical Research Strengthening Team of the CHRU of Tours, as well as the National Order of Nurses.\u003c/p\u003e\n\u003cp\u003eThe first author would like to thank Ms. GUINOISEAU Katty and Mr. THOMAS Guillaume for their support and guidance in drafting the article.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eParreira P, Sousa LB, Marques IA, Santos-Costa P, Braga LM, Cruz A, et al. Double-chamber syringe versus classic syringes for peripheral intravenous drug administration and catheter flushing: a study protocol for a randomised controlled trial. Trials. 2020;21(1):78. \u003c/li\u003e\n\u003cli\u003eGuenezan J, Drugeon B, O\u0026rsquo;Neill R, Caillaud D, S\u0026eacute;namaud C, Pouzet C, et al. Skin antisepsis with chlorhexidine-alcohol versus povidone iodine-alcohol, combined or not with use of a bundle of new devices, for prevention of short-term peripheral venous catheter-related infectious complications and catheter failure: an open-label, single-centre, randomised, four-parallel group, two-by-two factorial trial: CLEAN 3 protocol study. BMJ Open. 2019;9(4):e028549. \u003c/li\u003e\n\u003cli\u003eWallis MC, McGrail M, Webster J, Marsh N, Gowardman J, Playford EG, et al. Risk Factors for Peripheral Intravenous Catheter Failure: A Multivariate Analysis of Data from a Randomized Controlled Trial. Infect Control Hosp Epidemiol. 2014;35(1):63‑8. \u003c/li\u003e\n\u003cli\u003eGuanche-Sicilia A, S\u0026aacute;nchez-G\u0026oacute;mez MB, Castro-Peraza ME, Rodr\u0026iacute;guez-G\u0026oacute;mez J\u0026Aacute;, G\u0026oacute;mez-Salgado J, Duarte-Cl\u0026iacute;ments G. Prevention and Treatment of Phlebitis Secondary to the Insertion of a Peripheral Venous Catheter: A Scoping Review from a Nursing Perspective. Healthc Basel Switz. 2021;9(5):611. \u003c/li\u003e\n\u003cli\u003eGr\u0026uuml;ne F, Schrappe M, Basten J, Wenchel HM, Tual E, St\u0026uuml;tzer H, et al. Phlebitis rate and time kinetics of short peripheral intravenous catheters. Infection. 2004;32(1):30‑2. \u003c/li\u003e\n\u003cli\u003eMarsh N, Webster J, Ullman AJ, Mihala G, Cooke M, Chopra V, et al. Peripheral intravenous catheter non-infectious complications in adults: A systematic review and meta-analysis. J Adv Nurs. 2020;76(12):3346‑62. \u003c/li\u003e\n\u003cli\u003eAbdul-Hak CK, Barros \u0026Acirc;F. The incidence of phlebitis in a Medical Clinical Unit. Texto Contexto - Enferm. 2014;23(3):633‑8. \u003c/li\u003e\n\u003cli\u003eCapdevila-Reniu A, Capdevila JA. Peripheral venous catheter, a dangerous weapon. Key points to improve its use. Rev Clin Esp. 2017;217(8):464‑7. \u003c/li\u003e\n\u003cli\u003eBraga LM, Parreira PM, Oliveira A de SS, M\u0026oacute;nico LDSM, Arreguy-Sena C, Henriques MA. Phlebitis and infiltration: vascular trauma associated with the peripheral venous catheter. Rev Lat Am Enfermagem. 2018;26:e3002. \u003c/li\u003e\n\u003cli\u003eGoulart CB, Cust\u0026oacute;dio CS, Vasques CI, Ferreira EB, Diniz Dos Reis PE. Effectiveness of topical interventions to prevent or treat intravenous therapy-related phlebitis: A systematic review. J Clin Nurs. 2020;29(13‑14):2138‑49. \u003c/li\u003e\n\u003cli\u003eAtay S, Sen S, Cukurlu D. Phlebitis-related peripheral venous catheterization and the associated risk factors. Niger J Clin Pract. 2018;21(7):827‑31. \u003c/li\u003e\n\u003cli\u003eGarcia-Exp\u0026oacute;sito J, S\u0026aacute;nchez-Meca J, Almenta-Saavedra JA, Llubes-Arri\u0026agrave; L, Torn\u0026eacute;-Ruiz A, Roca J. Peripheral venous catheter-related phlebitis: A meta-analysis of topical treatment. Nurs Open. 2023;10(3):1270‑80. \u003c/li\u003e\n\u003cli\u003eNickel B. Peripheral Intravenous Access: Applying Infusion Therapy Standards of Practice to Improve Patient Safety. Crit Care Nurse. 2019;39(1):61‑71. \u003c/li\u003e\n\u003cli\u003eLv L, Zhang J. The incidence and risk of infusion phlebitis with peripheral intravenous catheters: A meta-analysis. J Vasc Access. 2020;21(3):342‑9. \u003c/li\u003e\n\u003cli\u003eCicolini G, Bonghi AP, Di Labio L, Di Mascio R. Position of peripheral venous cannulae and the incidence of thrombophlebitis: an observational study. J Adv Nurs. 2009;65(6):1268‑73. \u003c/li\u003e\n\u003cli\u003eCouzigou C, Lamory J, Salmon-Ceron D, Figard J, Vidal-Trecan GM. Short peripheral venous catheters: effect of evidence-based guidelines on insertion, maintenance and outcomes in a university hospital. J Hosp Infect. 2005;59(3):197‑204. \u003c/li\u003e\n\u003cli\u003eCapdevila JA, Guembe M, Barber\u0026aacute;n J, de Alarc\u0026oacute;n A, Bouza E, Fari\u0026ntilde;as MC, et al. 2016 Expert consensus document on prevention, diagnosis and treatment of short-term peripheral venous catheter-related infections in adult. Rev Espanola Quimioter Publicacion Of Soc Espanola Quimioter. 2016;29(4):230‑8. \u003c/li\u003e\n\u003cli\u003eLoveday HP, Wilson JA, Pratt RJ, Golsorkhi M, Tingle A, Bak A, et al. epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. J Hosp Infect. 2014;86 Suppl 1:S1-70. \u003c/li\u003e\n\u003cli\u003eAlexandrou E, Ray‐Barruel G, Carr PJ, Frost SA, Inwood S, Higgins N, et al. Use of Short Peripheral Intravenous Catheters: Characteristics, Management, and Outcomes Worldwide. J Hosp Med. 2018;13(5):E1-7. https://shmpublications.onlinelibrary.wiley.com/doi/10.12788/jhm.3039\u003c/li\u003e\n\u003cli\u003eZheng GH, Yang L, Chen HY, Chu JF, Mei L. Aloe vera for prevention and treatment of infusion phlebitis. Cochrane Database Syst Rev. 2014;2014(6):CD009162. \u003c/li\u003e\n\u003cli\u003eRavindra H, Patel KD. A quasi experimental study to evaluate effectiveness of glycerin magnesium sulphate dressing on phlebitis among patients undergoing peripheral intravenous infusion in selected hospital, Vadodara. Int J Med Res Health Sci. 2015;4(3):527. \u003c/li\u003e\n\u003cli\u003eTzolos E, Salawu A. Improving the frequency of visual infusion phlebitis (VIP) scoring on an oncology ward. BMJ Qual Improv Rep. 2014;3(1):u205455.w2364. \u003c/li\u003e\n\u003cli\u003eGallant P, Schultz AA. Evaluation of a visual infusion phlebitis scale for determining appropriate discontinuation of peripheral intravenous catheters. J Infus Nurs Off Publ Infus Nurses Soc. 2006;29(6):338‑45. \u003c/li\u003e\n\u003cli\u003eSimera I, Moher D, Hoey J, Schulz KF, Altman DG. The EQUATOR Network and reporting guidelines: Helping to achieve high standards in reporting health research studies. Maturitas. 2009;63(1):4‑6. \u003c/li\u003e\n\u003cli\u003evon Elm E, Altman DG, Egger M, Pocock SJ, G\u0026oslash;tzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. 2008;61(4):344‑9. \u003c/li\u003e\n\u003cli\u003eBrunt BA, Morris MM. Nursing Professional Development Evidence-Based Practice. In: StatPearls [Internet]. StatPearls Publishing; 2024 [cit\u0026eacute; 20 f\u0026eacute;vr 2024]. Disponible sur: http://www.ncbi.nlm.nih.gov/books/NBK589676/\u003c/li\u003e\n\u003cli\u003eHerrera E, Sandoval MC, Camargo DM, Salvini TF. Motor and Sensory Nerve Conduction Are Affected Differently by Ice Pack, Ice Massage, and Cold Water Immersion. Phys Ther. 2010;90(4):581‑91. \u003c/li\u003e\n\u003cli\u003eNadler SF, Weingand K, Kruse RJ. The physiologic basis and clinical applications of cryotherapy and thermotherapy for the pain practitioner. Pain Physician. 2004;7(3):395‑9. \u003c/li\u003e\n\u003cli\u003eAghajanloo A, Ghafourifard M, Haririan H, Gheydari P. Comparison of the effects of cryotherapy and placebo on reducing the pain of arteriovenous fistula cannulation among hemodialysis patients: A randomized control trial. J Nurs Midwifery Sci. 2016;3(1):59. \u003c/li\u003e\n\u003cli\u003eShin J, Kim GS, Sim H. Comparing the effectiveness of three pain relief methods for inserting a needle into the implanted venous access chemoport: A randomized controlled trial. Int J Nurs Pract. 2022;28(4):e12974. \u003c/li\u003e\n\u003cli\u003eWatkins AA, Johnson TV, Shrewsberry AB, Nourparvar P, Madni T, Watkins CJ, et al. Ice Packs Reduce Postoperative Midline Incision Pain and Narcotic Use: A Randomized Controlled Trial. J Am Coll Surg. 2014;219(3):511‑7. \u003c/li\u003e\n\u003cli\u003eBastami M. The Use of Ice Pack for Pain Associated with Arterial Punctures. J Clin Diagn Res. 2015;9(8):JC07-9\u003c/li\u003e\n\u003cli\u003eRay‐Barruel G, Polit DF, Murfield JE, Rickard CM. Infusion phlebitis assessment measures: a systematic review. J Eval Clin Pract. 2014;20(2):191‑202. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Nursing practice, phlebitis, peripheral venous catheter, treatments, survey ","lastPublishedDoi":"10.21203/rs.3.rs-4598400/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4598400/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e There are no international guidelines for the symptomatic management of phlebitis on peripheral venous catheters. Nurses therefore propose heterogeneous and low evidence-based management strategies to treat this complication. To explore the various management approaches for phlebitis on peripheral venous catheters proposed by registered nurses in France.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e Registered nurses and nurse executive practicing in both public and private sectors in France were invited to respond to a survey on the management of phlebitis on peripheral catheters. This survey was developed by nurses, nurse executive, and a physician. The survey was distributed via email through the National Order of Nurses from March 31, 2023, to April 30, 2023. No follow-up was conducted. A descriptive analysis of the survey results was then performed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e 3,038 healthcare providers practicing in 4 French regions responded to the survey. Phlebitis on peripheral venous catheters is most frequently encountered in medical wards. Respondents to the survey used heterogeneous strategies for the symptomatic treatment of phlebitis on peripheral venous catheters. 70° Alcohol dressings was the most common strategy reported (85.75% of respondents), applied for 92.40% of respondents without a medical prescription. The duration of treatment and its daily frequency of use were also highly variable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e Nursing practices for the symptomatic treatment of this complication are highly heterogeneous in France, often conducted without medical prescription, although the use of 70° alcohol dressing is considered as a medication in France, which could be debated.\u003c/p\u003e","manuscriptTitle":"Symptomatic Management of phlebitis on peripheral venous catheters: A national survey of nursing practice.","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-18 08:42:37","doi":"10.21203/rs.3.rs-4598400/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c973c38a-1b20-42a4-83b1-1dc1335c782a","owner":[],"postedDate":"July 18th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-07-22T11:57:30+00:00","versionOfRecord":[],"versionCreatedAt":"2024-07-18 08:42:37","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4598400","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4598400","identity":"rs-4598400","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}