Translation, cultural adaptation, and validation of the Venous International Assessment Scale to European Portuguese

Santos-Costa P.J., Vieira M.M., Graveto J.M., Lopes M., Torre-Montero J.C., Peterlini M.A., Pedreira M.D.

Santos-Costa P., Paiva-Santos F., Sousa L.B., Bernardes R.A., Ventura F., Salgueiro-Oliveira A., Parreira P., Vieira M., Graveto J.

Santos-Costa P., Paiva-Santos F., Bernardes R.A., Sousa L.B., Ventura F., Faria J., Gil I., Parreira P., Salgueiro-Oliveira A., Vieira M., Graveto J.

While previous studies suggest that patient risk factors such as advanced age and cancer disease are accountable for difficult intravenous access (DIVA), very few studies have studied how the coexistence of both risk factors impacts care outcomes. We aimed to compare DIVA status and peripheral intravenous catheter (PIVC) related care outcomes in adults and older adults with cancer. A retrospective analysis was conducted using an existing dataset from a large Action-Research project conducted with the nursing team from a surgical oncology ward in Portugal. Study findings show that one in every three older adults is at moderate to high risk of DIVA. Compared to younger adults, this cohort is less likely to experience first-attempt success in PIVC insertion (69.7% versus 82%; χ2(1) = 4.17, p = 0.046), a higher number of consecutive puncture attempts (t(198) = -2.67, p = 0.008) and PIVC-related adverse events (23.6% versus 13.5%). These findings support the importance of formally conducting DIVA assessment in oncology settings, using structured approaches and instruments, as well as introducing vein-locating technologies such as ultrasound imaging and electrical stimulation technology that promote efficient, safe, and sustainable nursing practice.

Lopes M., Torre-Montero J.C., Peterlini M.A., Pedreira M.D.

RESUMO Objetivo: Validar a tradução para língua portuguesa do Brasil e analisar a adaptação cultural da Escala Venous International Assessment. Métodos: Estudo observacional dado pela aplicação da técnica de Delphi e avaliação da equivalência por especialistas. Os resultados foram analisados mediante a pontuação por item e cálculos de índices de validade de conteúdo de item, escala e concordância universal. Resultados: Foram necessárias três rodadas de avaliação para consenso. No decorrer do processo, foram incorporados conteúdos explicativos à escala original, propondo-se a Escala VIA - Revised. Esta obteve índice de validade de conteúdo de 0,96 e concordância universal de 0,78. Na etapa de análise da adequação transcultural, foi obtido índice de 0,77. A maioria (90,5%) dos participantes julgou de modo positivo a propriedade da escala de apoio à decisão. Conclusão: A Escala VIA foi validada e adaptada culturalmente para a língua portuguesa do Brasil, gerando proposição da Escala VIA - Revised (VIA-R).

Lopes M., Torre-Montero J.C., Peterlini M.A., Pedreira M.D.

ABSTRACT Objective: To validate the Brazilian Portuguese translation and analyze the cultural adaptation of the Venous International Assessment Scale. Methods: Observational study by employing the Delphi technique and an equivalence evaluation by experts. The results were analyzed using item scores and by content validity index calculations of item, scale, and universal agreement. Results: Three rounds of evaluation were necessary for consensus. Explanatory contents were incorporated into the original scale throughout the process, resulting in a new version: VIA Scale - Revised. This scale obtained a content validity index of 0.96 and a universal agreement of 0.78. In the cross-cultural adequacy analysis phase, a score of 0.77 was obtained. The majority (90.5%) of the participants judged the scale’s decision support property as positive. Conclusion: The VIA Scale was validated and culturally adapted to the Brazilian Portuguese language, resulting in the VIA Scale - Revised (VIA-R).

Santos-Costa P., Alves M., Sousa C., Sousa L.B., Paiva-Santos F., Bernardes R.A., Ventura F., Salgueiro-Oliveira A., Parreira P., Vieira M., Graveto J.

Guaranteeing peripheral venous access is one of the cornerstones of modern healthcare. Recent evidence shows that the lack of adequate clinical devices can result in the provision of substandard care to patients who require peripheral intravenous catheterization (PIVC). To address this challenge, we aimed to develop a PIVC pack for adult patients and assess the usability of this new device. Methods: Following a mix-method design, the PIVC pack development and usability assessment were performed in two phases with the involvement of its potential end-users (nurses). In phase one (concept and semi-functional prototype assessment), focus group rounds were conducted, and a usability assessment questionnaire was applied at each stage. In phase two (pre-clinical usability assessment), a two-arm crossover randomised controlled trial (PIVC pack versus traditional material) was conducted with nurses in a simulated setting. Final interviews were conducted to further explore the PIVC pack applicability in a real-life clinical setting. Results: High average usability scores were identified in each study phase. During the pre-clinical usability assessment, the PIVC pack significantly reduced procedural time (Z = −2.482, p = 0.013) and avoided omissions while preparing the required material (Z = −1.977, p = 0.048). The participating nurses emphasised the pack’s potential to standardise practices among professionals, improve adherence to infection control recommendations, and enhance stock management. Conclusions: The developed pack appears to be a promising device that can assist healthcare professionals in providing efficient and safe care to patients requiring a PIVC. Future studies in real clinical settings are warranted to test its cost-effectiveness.

Santos-Costa P., Paiva-Santos F., Sousa L.B., Bernardes R.A., Ventura F., Salgueiro-Oliveira A., Parreira P., Vieira M., Graveto J.

Contrary to many international settings, there are no clinical guidelines for peripheral intravenous catheter (PIVC) insertion and maintenance in Portugal. We sought to derive an international consensus on a PIVC bundle that could guide Portuguese nurses’ clinical decision-making in this scope. Methods: Two international vascular access specialist groups participated in an online Delphi panel. During the first round, specialists (n = 7) were sent a summary report from a previous observational study conducted in a surgical ward in Portugal. Based on the report findings, specialists were asked to provide five to eight PIVC insertion and maintenance interventions. Then, another set of specialists (n = 7) scored and revised the recommendations until a consensus was reached (≥70% agreement). The PIVC bundle was made available and discussed with the surgical ward’s nurses. Results: After three rounds, a consensus was achieved for five evidence-informed interventions: (i) involve the person and assess the peripheral venous network; (ii) maintain an aseptic no-touch technique; (iii) ensure proper catheter dressing and fixation; (iv) perform catheter flush & lock; (v) test the peripheral venous catheter’s functionality and performance at each shift. Conclusion: The final version of the PIVC bundle achieved consensus among international experts. Despite the positive feedback provided by the ward nurses, future studies are warranted to assess its effectiveness in standardizing PIVC care delivery and its potential implications for care outcomes in Portuguese clinical settings.

Santos-Costa P., Paiva-Santos F., Sousa L.B., Bernardes R.A., Ventura F., Fearnley W.D., Salgueiro-Oliveira A., Parreira P., Vieira M., Graveto J.

A significant number of adult oncology patients require at least one peripheral intravenous catheter to fulfill their therapeutic plan. Recent evidence indicates that catheter failure rates are high in this cohort, impacting care outcomes and patient experience during cancer treatment. This reality represents a challenge to nurses worldwide since in most international settings they are responsible for delivering quality care during the insertion and maintenance of such devices. This study aims to explore current nursing practices regarding the insertion, maintenance, and surveillance of peripheral intravenous catheters in oncology patients. A two-phase mix-method study was conducted with the nursing team from the surgical ward of a large oncology hospital in Portugal. In phase one (observational prospective study), nurses’ practices during catheter insertion and maintenance were observed by the research team and recorded using standardized instruments and validated scales. In phase two, three online focus groups were conducted with the nursing team to present the results observed in phase one and explore their perceptions of current practices. All ethical principles were assured throughout the study. Significant divergent practices were observed and identified by the nurses, especially concerning patient involvement, nurses’ adherence to the aseptic, non-touch technique, catheter stabilization and dressing, and catheter flushing and locking. Such practices may partially explain the high complication rate found (26%) and substantiate the need for future intervention in this field.