Nurse’s Notes: Using VIP Score in Intravenous Therapy

Posted: August 2, 2019 in Nurse
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According to Zhang G et al, around 20 to 70 % of patients receiving intravenous therapy in the hospital may experience infusion phlebitis.  Inflamed veins could disrupt the therapy, which is why it is essential for nurses to identify early signs and symptoms of phlebitis.

To help my fellow nurses, I wish to share two scales for identifying phlebitis and interventions necessary to prevent and manage this condition,

Phlebitis Scale of Infusion Nurses Society

Infusion Nursing Standards of Practice shares that;

Grade 0 – No symptoms
Grade 1 – Erythema at access site with or without pain
Grade 2 – Pain at access site with erythema and/or edema
Grade 3 – Pain at access site with erythema and/or edema, streak formation, palpable venous cord.
Grade 4 – Pain at access site with erythema and/or edema, streak formation, palpable venous cord greater than 1 in in length; purulent drainage.

This phlebitis scale has been used by nurses for years. It was my go-to scale for my patients.

Visual Infusion Phlebitis Score

Another scale for phlebitis if Visual Infusion Phlebitis (VIP) score. It was developed by Andrew Jackson, Consultant Nurse Intravenous Therapy and Care of Rotherham General Hospitals, NHS Trust and made available after evaluation in 2006.

Infusion Phlebitis Score

It is a good visual tool for nurses caring for patients in intravenous therapy.

Prevention and Management of Phlebitis

Assessment and monitoring of intravenous therapy site are essential for the prevention of infusion phlebitis. Nurses are also responsible to change every 24hours the site of cannula or catheter.

Once infusion phlebitis occurs, a nurse must intervene according to the severity of condition. I find Jackson’s suggested intervention in his VIP score useful whenever I face this situation. For example, a nurse should resite the cannula for a patient with an early stage of phlebitis. Before doing the procedure, inform and explain to the patient why you are doing the procedure.

So nurses, do not guess the severity of infusion phlebitis and absentmindedly document it. Use either of these infusion phlebitis scales!

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