SCOPUS analysis of publications on nursing and phlebitis

Abstract

Objectives: The aim of our study was to analyze and guide future research on phlebitis, which is one of the complications of nursing and local peripheral intravenous catheter.

Materials and methods: In the study, the method of data collection through document analysis was used. The universe of the research in this study consisted of publications published in journals within the scope of the SCOPUS database (http://www.scopus.com/), which is the largest summary and citation database of the literature, until March 13, 2021. The publications containing the keywords “phlebitis” and “nursing” in English were examined in the title of the article.

Results: There were 298 publications in total, with 247 of them being articles. São Paulo (n=10) and Griffith University (n=10) had the most publications. It was determined that after 2001, there was a significant increase in the number of publications on this subject. The year with the most publications (n=21) was 2020. In this regard, the United States of America (n=132) was the most productive country. There were publications from 39 different countries. Our country was listed ninth. 271 of the publications were written in English. There were 389 citations for the most cited article, and 40 articles got no citations at all. Our country had only seven publications (2.34%) and 31 authors.

Conclusion: The number of publications on phlebitis in nursing, both internationally and in our country, is quite low. There is a global need for studies on the subject, which is widely used in nursing practice.

Introduction

The intravenous (IV) route is a treatment method that involves injecting drugs and fluids directly into the venous system. The main purposes of IV administration are to correct the patient's fluid and electrolyte imbalance, administer medication, to provide nutrition, blood and blood products, and radio-opaque substances. A common type of catheter is peripheral intravenous catheters (PIVC) for IV applications. Peripheral intravenous catheters application is one of the most common nursing practices in patients admitted to the hospital. Local or systemic complications may develop if PIVC is not used under the proper conditions. The most common of these complications is phlebitis, which presents as swelling, erythema, soreness, and tenderness in the skin around the catheter insertion site for around 2 cm, infection of the catheter insertion site, and inflammation of the intima layer of the vein.[1-3] Phlebitis is a preventable complication if the risk factors that contribute to its development are avoided.[2]

This is one of the basics of nursing practice, and there have been numerous studies on the subject. The aim of our study was to analyze and guide future research on phlebitis, which is one of the complications of nursing and local PIVC.

Patients and Methods

Qualitative studies are holistic, experienceadvantaged, realistic, interpreting and analyzing the results obtained, and were previously used in social sciences; however, their use in the field of health is increasing due to their scientific contribution.[4,5]

In the study, the method of data collection through document analysis was used. The universe of the research in this study consisted of publications published in journals within the scope of the SCOPUS database (http://www. scopus.com/), which is the largest summary and citation database of the literature, until March 13^th, 2021. The publications containing the keywords “phlebitis” and “nursing” in English were examined in the title of the article. The “content analysis” technique, which is one of the qualitative research methods used in previous studies, was used to analyze the data. Previously, similar methods studies were used as examples.[6,7]

Following the determination of the global situation, the publications from our country were deeply examined. The authors, years, institutions, journals, citation counts, and field-weighted citation impacts were analyzed.

Results

There were 298 publications in total, with 247 of them being articles. São Paulo (n=10) and Griffith University (n=10) had the most publications. Menzies Health Institute Queensland (n=8) and Royal Brisbane and Women's Hospital (n=7) were the only institutions with more than five research on this subject. It has been determined that there has been a significant increase in the number of publications on this subject since 2001. The year with the most publications (n=21) was 2020 (Table 1, Figure 1).

Table 1. Distribution of publications by characteristics

Figure 1. Distribution of publications by years.

Rickard, CM was the author with the most publications (n=9) (Figure 2). The United States of America (n=132) was the most productive country in this regard. There were publications from 39 different countries. Our country was listed ninth (Figure 3). 271 of the publications were written in English, 17 in Spanish, 10 in Portuguese, and eight in French. The majority of publications were in journals, including Journal of Infusion Nursing (n=49), Journal of Intravenous Nursing (n=23), NITA (n=14), Critical Care Nurse (n=7), and The Journal of the Association for Vascular Access (JAVA) (n=7). The most frequently used keywords were Human (n=256), Phlebitis (n=224), Article (n=163), Humans (n=154), Female (n=119), Male (n=115), Adult (n=99), Priority Journal (n=94), Catheterization, Peripheral (n=93), and Catheterization (n=87).

Figure 2. The authors with the most publications.[8]

Figure 3. Distribution of publications by country.

There were 389 citations for the most cited article, and 40 articles got no citations at all. Table 2 shows an analysis of the 10 most cited articles.

Table 2. Analysis of the 10 most cited articles

There were only seven publications (2.34%) and 31 authors from our country. Büyükyılmaz[8] had the most publications. Seven of these publications were also articles and all were written in English. There were two articles in 2018, as well as one in 2003, 2008, 2014, 2019, and 2020. In other years, no article in this field was found.

Discussion

Phlebitis due to the use of peripheral intravenous catheters, which is part of nursing practices worldwide, is a global problem. Despite medical advancements, this problem is still frequently detected. It is a subject that the field of nursing and other related medical branches do not emphasize scientifically, and the number of publications is relatively low. Therefore, we planned to analyze the publications, compare the situation in our country, and raise awareness of the deficiency in this issue as part of our research.

The acceptable rate of phlebitis has been reported as <5%, however, due to variation, the rates reported in the literature are likely to range from 0 to 91%. There are 71 phlebitis scales available for infusion phlebitis assessment measures, but none of them have been fully validated.[10-14] The incidence of eight signs and symptoms used in the diagnosis of phlebitis with a peripheral intravenous catheter or a short peripheral catheter, as well as their level of correlation, were investigated in a study. At 5,907 catheter insertion sites, a total of 22,789 observations per day of six signs (swelling, erythema, leakage, palpable venous cord, purulent discharge, and temperature) and two symptoms (pain and tenderness) were analyzed. Most signs and symptoms of phlebitis have been reported to occur only occasionally or rarely, with sensitivity being the highest incidence finding.[13] In another study, 210 patients were enrolled in three hospitals, with 247 pairs of observation groups. The most sensitive scales were determined to be Catney and Rittenberg, whereas the least sensitive scales were Curran, Lanbeck, and Rickard. Only the Catney (pain, tenderness, erythema, or palpable cord) and Rittenberg (erythema, swelling, tenderness, or pain) scales were found to be acceptable.[14] However, as with these publications, it is worth noting that there is no clarity about this subject, which is quite common in daily practice, even in terms of definition. Furthermore, no bibliometric study on phlebitis has been found in the literature, which can be accessed both nationally and internationally.

In the analysis, 235 publications with the same keywords were found in the PubMed database. It is necessary to increase the number of publications in this field as a consequence of the analysis in both databases. According to PubMed, the first publication was in 1964, and the number of publications increased after 2003. After 2001, the number of publications on this subject increased significantly, according to our findings. Moreover, the search of PubMed revealed that all of the publications were published in nursing journals.

Limitations of our study: Our study is confined to theses written in our country between 1994 and 2020, which is a significant limitation.

Conclusion

Phlebitis due to the use of peripheral intravenous catheters, which is part of nursing practices worldwide, is a global problem. Despite medical advancements, this problem is still frequently detected. It is a subject that the field of nursing and other related medical branches do not emphasize scientifically, and the number of publications is relatively low. Therefore, we planned to analyze the publications, compare the situation in our country, and raise awareness of the deficiency in this issue as part of our research.

The acceptable rate of phlebitis has been reported as <5%, however, due to variation, the rates reported in the literature are likely to range from 0 to 91%. There are 71 phlebitis scales available for infusion phlebitis assessment measures, but none of them have been fully validated.[10-14] The incidence of eight signs and symptoms used in the diagnosis of phlebitis with a peripheral intravenous catheter or a short peripheral catheter, as well as their level of correlation, were investigated in a study. At 5,907 catheter insertion sites, a total of 22,789 observations per day of six signs (swelling, erythema, leakage, palpable venous cord, purulent discharge, and temperature) and two symptoms (pain and tenderness) were analyzed. Most signs and symptoms of phlebitis have been reported to occur only occasionally or rarely, with sensitivity being the highest incidence finding.[13] In another study, 210 patients were enrolled in three hospitals, with 247 pairs of observation groups. The most sensitive scales were determined to be Catney and Rittenberg, whereas the least sensitive scales were Curran, Lanbeck, and Rickard. Only the Catney (pain, tenderness, erythema, or palpable cord) and Rittenberg (erythema, swelling, tenderness, or pain) scales were found to be acceptable.[14] However, as with these publications, it is worth noting that there is no clarity about this subject, which is quite common in daily practice, even in terms of definition. Furthermore, no bibliometric study on phlebitis has been found in the literature, which can be accessed both nationally and internationally.

In the analysis, 235 publications with the same keywords were found in the PubMed database. It is necessary to increase the number of publications in this field as a consequence of the analysis in both databases. According to PubMed, the first publication was in 1964, and the number of publications increased after 2003. After 2001, the number of publications on this subject increased significantly, according to our findings. Moreover, the search of PubMed revealed that all of the publications were published in nursing journals.

Limitations of our study: Our study is confined to theses written in our country between 1994 and 2020, which is a significant limitation.

Cite this article as: Alkan Çeviker S, Öntürk Akyüz H. SCOPUS analysis of publications on nursing and phlebitis. D J Med Sci 2021;7(3):1-6. D J Med Sci 2023;9(1):1-6. doi: 10.5606/fng.btd.2023.23.

The ethical dimension of the research: There is no need for ethics committee approval because the field publication search is used in the research. The study was conducted in accordance with the principles of the Declaration of Helsinki.

Data Sharing Statement:
The data that support the findings of this study are available from the corresponding author upon reasonable request.

All authors contributed equally to the article.

The authors declared no conflicts of interest with respect to the authorship and/ or publication of this article.

The authors received no financial support for the research and/or authorship of this article.

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