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Aim: To explore barriers and facilitators that influence adherence to evidence‐based guidelines for peripheral intravenous catheter care in different hospital wards. Design: Sequential explanatory mixedmethod study design, with qualitative data used to elaborate on quantitative findings. Method: Data were collected between March 2021 and March 2022 using the previously validated Peripheral Intravenous Catheter mini questionnaire (PIVC‐miniQ) on each ward in a tertiary hospital in Norway. Survey completion was followed by individual interviews with nurses from selected wards. The Pillar Integration Process was used to integrate and analyse the quantitative and qualitative findings. Results: The PIVC‐miniQ screening assessed 566 peripheral intravenous catheters in 448 patients in 41 wards, and we found variation between wards in the quality of care. Based on the quantitative variation, we interviewed 24 nurses on wards with either excellent or not as good quality. The integration of the quantitative and qualitative findings in the study enabled an understanding of factors that influence nurses' adherence to the care of peripheral venous catheters. One main theme and four subthemes emerged. The main finding was that ward culture affects education practice, and this was evident from four subthemes: (1) Deviation from best practice, (2) Gaps in education and clinical training, (3) Quality variation between wards and (4) The importance of supportive leadership. Conclusion: This mixed method study is the first study to explore reasons for variability in peripheral intravenous catheter quality across hospital wards. We found that ward culture was central to catheter quality, with evidence of deviations from best practice correlating with observed catheter complications. Ward culture also impacted nursing education, with the main responsibility for learning peripheral intravenous catheter management left to students' clinical training placements. Addressing this educational gap and fostering supportive leadership, including champions, will likely improve peripheral intravenous catheter care and patient safety. Implications for the Profession and/or Patient Care: Nurses learn good peripheral intravenous catheter care in wards with supportive leaders and champions. This implies that the quality of nursing practice and patient outcomes are situational. Nurses need a strengthened emphasis on peripheral catheter quality in the undergraduate curriculum, and nurse leaders must emphasize the quality of catheter care in their wards. Impact: The study findings impact nurse leaders who must commit to quality and safety outcomes by appointing and supporting local ward champions for promoting peripheral intravenous catheter care. This also impacts nursing education providers, as the emphasis on catheter care must be strengthened in the undergraduate nursing curriculum and continually reinforced in the hospital environment, particularly when guidelines are updated. Reporting Method: The study adhered to the Good Reporting of A Mixed Method Study (GRAMM). Patient or Public Contribution: A patient representative has been involved in planning this study. [ABSTRACT FROM AUTHOR]

Background: During the COVID619 pandemic, hospitals implemented several infection control measures that could affect the quality of insertion and management of peripheral intravenous catheters $PIVCs). Pre-pandemic studies found a high rate of PIVC complications, but no studies to date have assessed the quality during the pandemic period. Objective: This prospective study aimed to investigate the effect of the pandemic on PIVC management and care. Method: Data were collected from adult patients $_18 years) at a university hospital in Norway during a three-week period in February 2020 (pre-pandemic: PP group) and a three-week period in October 2020 (pandemic: P group). The primary outcome measure was PIVC quality as determined by the validated PIVC Mini Questionnaire $PIVC-miniQ%, which consists of 16 items relating to deviations from best practice. Results: The study included 483 PIVCs and 413 patients. Of these, 238 PIVCs $49.3%% were collected in the PP group and 245 $50.7%% in the P group. In the PP group, 41.8% of the PIVCs were 18 gauge (green PIVC% or larger, compared to 53.3% in the P group. The median PIVC-miniQ score was 2 in both groups, with a range of 0710 in the PP group and 078 in the P group. Improved quality in terms of fewer patients reporting pain was registered in the P group $14.3% compared to 6.7%%, and 36.3% had blood in the IV line in the PP group, compared to 26.5% in the P group. However, a poorer quality was observed in the P group for the PIVC-miniQ items 'purulence' $0% in the PP group compared to 6% in the P group) and 'loose dressing' $15.2% in the PP group compared to 24.9% in the P group). Documentation of PIVC insertion and indication was equally insufficient in both groups (p = 0.857%. Conclusion: Although some differences were observed at item level, the PIVC quality as measured by the PIVC-miniQ total score remained unchanged during the pandemic. Given the low workload of our hospital during the pandemic, it is a paradox that the PIVC care did not improve. [ABSTRACT FROM AUTHOR]

Aims: Intravenous amiodarone is an irritant of peripheral blood vessels with phlebitis as an adverse effect. The aims were to determine the incidence of intravenous amiodarone-induced phlebitis, to describe adherence to a clinical practice guideline, and to determine how characteristics were distributed between those with and without phlebitis. Methods and results: A prospective observational study was conducted. Adult patients treated with amiodarone through a peripheral intravenous catheter (PIVC) or a central venous catheter were included. PIVC characteristics were measured using the PIVC mini questionnaire. Patients with ≥two signs of phlebitis were categorized as having phlebitis. Adherence to the clinical practice guideline was registered on a standard abstract sheet. Data were collected from the amiodarone start-up to 2 days after the amiodarone was discontinued. In total, 124 patients with amiodarone infusions were observed, of which 69% were administered via a PIVC. The phlebitis rate was 44%. Fifty-three per cent developed amiodarone-induced phlebitis during the infusion phase, while 47% presented phlebitis during the post-infusion phase. The three most observed signs or symptoms of phlebitis were redness (87%), pain (81%), and swelling (71%). The most commonly used PIVC site was the elbow, and 35% of the PIVCs were large (18 gauge), which was the last preferred site and size according to the clinical practice guideline. Conclusion: A large proportion of the patients developed amiodarone-induced phlebitis. The adherence to the clinical practice guideline was not optimal according to the PIVC recommendations. Prevention of amiodarone-induced phlebitis should have high priority to reduce patient harm. Graphical Abstract [ABSTRACT FROM AUTHOR]

Annotations enrich text corpora and provide necessary labels for natural language processing studies. To reason and infer underlying implicit knowledge captured by labels, an ontology is needed to provide a semantically annotated corpus with structured domain knowledge. Utilizing a corpus of adverse event documents annotated for sepsis-related signs and symptoms as a use case, this paper details how a terminology and corresponding ontology were developed. The Annotated Adverse Event NOte TErminology (AAENOTE) represents annotated documents and assists annotators in annotating text. In contrast, the complementary Catheter Infection Indications Ontology (CIIO) is intended for clinician use and captures domain knowledge needed to reason and infer implicit information from data. The approach taken makes ontology development understandable and accessible to domain experts without formal ontology training. [ABSTRACT FROM AUTHOR]

The article focuses on the issue of phlebitis related to peripheral intravenous catheters (PIVCs) and its impact on patient safety, including the underreporting of phlebitis as an adverse event and the potential effectiveness of proximal massage and palm fisting in preventing phlebitis.

Background: Total knee arthroplasty is experienced as a painful procedure, and pain after surgery seems to be the most limiting factor for early mobilisation. Physical exercise is of utter importance for avoiding complications such as persistent pain and functional limitations. A fast‐track pathway aims at improving patient outcome, and patients are now discharged 2–3 days after surgery. Little is known about how the patients cope with pain, exercise or daily activities at home. Aim: To explore the experience of patients undergoing total knee arthroplasty in a fast‐track pathway during the first 2 weeks after surgery. Design: Qualitative design. Methods: Three focus group interviews, including 13 patients from two different units of an orthopaedic department in central Norway, were conducted from May to June 2015. The interviews were analysed using Malteruds` method of systematic text condensation. Findings: The main finding was the patients' determination and ability to cope at home. The fast‐track pathway seemed to enable patients to take an active role in own self‐care. The patient's coping capacity was strengthened by education, knowledge and predictability. Four main areas related to coping emerged after discharge. First, the majority of patients expressed that it was good to come home and take responsibility for their own rehabilitation. Second, prerequisites for feeling secure after returning home were highlighted. Third, the patients seemed empowered by sharing experiences with others. Fourth, postoperative pain was prevalent in many patients after discharge, but the patients seemed prepared by information provided in the fast‐track pathway. Conclusion: The fast‐track pathway released coping skills and resources among the patients. The expectation of, and preparation for early discharge made the patients feel confident when discharged few days after surgery. The patients expected to take great responsibility for their own rehabilitation process. [ABSTRACT FROM AUTHOR]

Background: Pain relief is likely to be the most important long-term outcome for patients undergoing total knee arthroplasty (TKA). However, research indicates that persistent pain (> 3 months) is a considerable problem, affecting up to 34 % of patients. Pain catastrophizing might contribute to acute and persistent pain experienced after surgery. The primary aim of the present study was to examine the association between preoperative pain catastrophizing and postoperative pain in patients undergoing TKA up to one year after surgery. Second, we wanted to investigate a possible shift in postoperative catastrophizing.Methods: In this prospective cohort study, 71 TKA patients were included consecutively between January and June 2013. Pain was assessed with the Brief Pain Inventory (BPI) and the item "average pain" was used as the main outcome. Pain catastrophizing was measured by the Pain Catastrophizing Scale (PCS). Questionnaires were completed prior to surgery (baseline) and at two days, two weeks, eight weeks and one year postoperatively.Results: Mean (SD) preoperative pain score was 5.4 (2.2), reduced to 2.9 (2.3) after eight weeks and 2.4 (2.4) after one year (p < 0.001). The overall median preoperative PCS score was 17.0 (7.8-28.3). The overall model estimated PCS mean score was 7.6 at eight weeks and 6.5 at one year follow-up. The results at eight weeks and one year follow-up were both significantly lower than the preoperative value (p < 0.001). The preoperative PCS score was not associated with the postoperative pain score (p = 0.942), while preoperative pain was a significant covariate in the mixed linear model (p < 0.001).Conclusions: No associations were found between preoperative pain catastrophizing and pain eight weeks or one year after surgery. The decrease in PCS-scores challenges evidence regarding the stability of pain catastrophizing. However, larger studies of psychological risk factors for pain after TKA are warranted. [ABSTRACT FROM AUTHOR]

An amendment to this paper has been published and can be accessed via the original article. [ABSTRACT FROM AUTHOR]

Background: Peripheral intravenous catheters (PIVCs) account for a mean of 38% of catheter associated bloodstream infections (CABSI) with Staphylococcus aureus, which are preventable if deficiencies in best practice are addressed. There exists no feasible and reliable quality surveillance tool assessing all important areas related to PIVC quality. Thus, we aimed to develop and test feasibility and reliability for an efficient quality assessment tool of overall PIVC quality.Methods: The Peripheral Intravenous Catheter- mini Questionnaire, PIVC-miniQ, consists of 16 items calculated as a sum score of problems regarding the insertion site, condition of dressing and equipment, documentation, and indication for use. In addition, it contains background variables like PIVC site, size and insertion environment. Two hospitals tested the PIVC-miniQ for feasibility and inter-rater agreement. Each PIVC was assessed twice, 2-5 min apart by two independent raters. We calculated the intraclass correlation coefficient (ICC) for each hospital and overall. For each of the 16 items, we calculated negative agreement, positive agreement, absolute agreement, and Scott's pi.Results: Sixty-three raters evaluated 205 PIVCs in 177 patients, each PIVC was assessed twice by independent raters, in total 410 PIVC observations. ICC between raters was 0.678 for hospital A, 0.577 for hospital B, and 0.604 for the pooled data. Mean time for the bedside assessment of each PIVC was 1.40 (SD 0.0007) minutes. The most frequent insertion site symptom was "pain and tenderness" (14.4%), whereas the most prevalent overall problem was lack of documentation of the PIVC (26.8%). Up to 50% of PIVCs were placed near joints (wrist or antecubital fossae) or were inserted under suboptimal conditions, i.e. emergency department or ambulance.Conclusions: Our study highlights the need for PIVC quality surveillance on ward and hospital level and reports the PIVC-miniQ to be a reliable and time efficient tool suitable for frequent point-prevalence audits. [ABSTRACT FROM AUTHOR]