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Rationale, aims and objectives Phlebitis is a common and painful complication of peripheral intravenous cannulation. The aim of this review was to identify the measures used in infusion phlebitis assessment and evaluate evidence regarding their reliability, validity, responsiveness and feasibility. Method We conducted a systematic literature review of the Cochrane library, Ovid MEDLINE and EBSCO CINAHL until September 2013. All English-language studies (randomized controlled trials, prospective cohort and cross-sectional) that used an infusion phlebitis scale were retrieved and analysed to determine which symptoms were included in each scale and how these were measured. We evaluated studies that reported testing the psychometric properties of phlebitis assessment scales using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines. Results Infusion phlebitis was the primary outcome measure in 233 studies. Fifty-three (23%) of these provided no actual definition of phlebitis. Of the 180 studies that reported measuring phlebitis incidence and/or severity, 101 (56%) used a scale and 79 (44%) used a definition alone. We identified 71 different phlebitis assessment scales. Three scales had undergone some psychometric analyses, but no scale had been rigorously tested. Conclusion Many phlebitis scales exist, but none has been thoroughly validated for use in clinical practice. A lack of consensus on phlebitis measures has likely contributed to disparities in reported phlebitis incidence, precluding meaningful comparison of phlebitis rates.

In intervention studies in which randomization to groups is not possible, researchers typically use quasi-experimental designs. Time series designs are strong quasi-experimental designs but are seldom used, perhaps because of technical and analytic hurdles. Statistical process control (SPC) is an alternative analytic approach to testing hypotheses about intervention effects using data collected over time. SPC, like traditional statistical methods, is a tool for understanding variation and involves the construction of control charts that distinguish between normal, random fluctuations (common cause variation), and statistically significant special cause variation that can result from an innovation. The purpose of this article is to provide an overview of SPC and to illustrate its use in a study of a nursing practice improvement intervention.

Aims and objectives. To undertake an outcomes evaluation of a Hospital in the Nursing Home (HINH) admission avoidance programme. Background. Admission avoidance type services such as Hospital in the Home have a place in improving service delivery for certain population groups. Research related to HINH has been limited, derived from various different health care systems internationally and results are varied. Design. A quasi-experimental study was conducted at one regional hospital. Routinely collected health information system data from two separate data sources were linked to undertake analysis. Methods. Those in the intervention group were matched to a comparison group of patients on the basis of three characteristics (age, gender and diagnostic category). Other factors that could affect a patient’s hospital outcomes and length of stay (LOS) were statistically controlled for. Participants were aged care facility residents enrolled in a HINH programme (n = 62) and a matched group receiving usual in-hospital care (n = 115). Emergency department (ED) outcome measures included LOS and re-presentation. Hospital admission–related outcome measures included episode of care LOS, in-hospital LOS and hospital readmission. Results. A significant independent relationship between HINH programme enrolment and shorter in-hospital LOS was identified even after adjusting for other characteristics OR 0·16 (95% CI 0·28, 0·99 p

Intention-to-treat (ITT) in randomized controlled trials involves keeping participants in the treatment groups to which they were randomized regardless of whether they withdraw following randomization. Intention-to-treat is a strategy for maintaining the integrity of randomization and strengthening the trial's internal validity. Although ITT is advocated by the Consolidated Standards of Reporting Trials (CONSORT) guidelines, there is confusion about what ITT means and little specific advice on how to achieve it. The purpose of this article is to present definitions of ITT and to suggest strategies for implementing ITT as a total design strategy in nursing clinical trials. Recommendations are offered regarding study planning, study design, subject retention, sampling, data collection, data analysis, and reporting within the context of ITT.

Scale developers often provide evidence of content validity by computing a content validity index (CVI), using ratings of item relevance by content experts. We analyzed how nurse researchers have defined and calculated the CVI, and found considerable consistency for item-level CVIs (I-CVIs). However, there are two alternative, but unacknowledged, methods of computing the scale-level index (S-CVI). One method requires universal agreement among experts, but a less conservative method averages the item-level CVIs. Using backward inference with a purposive sample of scale development studies, we found that both methods are being used by nurse researchers, although it was not always possible to infer the calculation method. The two approaches can lead to different values, making it risky to draw conclusions about content validity. Scale developers should indicate which method was used to provide readers with interpretable content validity information.