Phlebitis associated with peripheral venous catheter placement: systematic review

Flebitis asociada a la colocación de catéteres venosos periféricos: revisión sistemá= tica

= ¹=	Leonor del Rocío Ulloa Heras=	https://orcid.org/0000-0001-9475-5727=
<= /span>	Maestría en Gestión del Cuidado, Posgrado de la Universidad Católica, Ecuador leitoulloa@hotmail.com
= ²=	Francy Hollminn Salas Contreras=	https://orcid.org/0000-0003-2207-1953=
<= /span>	Carrera de Enfermería de la Universidad Católica, Ecuador franholsa= c@yahoo.es
= ³=	María Gabriela Morgado Tapia=	http://orcid.org/0000-0003-0216-3666
<= /span>	Laboratorio de Psicometría, Psicología Comparada y Etología (LABPPCE) gmorgado@una= b.cl

	Artículo de Investigación Científica y Tecnológi= ca Enviado: 28/01/2022 Revisado: 11/02/2022 Aceptado: 02/03/2022 Publicado:10/07/2022 DOI: https://doi.o= rg/10.33262/anatomiadigital.v5i3.2241
	&= nbsp;
&= nbsp; Cítese= :	&= nbsp;	&= nbsp; Ulloa Heras, L. del R., Salas Contreras, F. H., & Morgado Tapia, M. G. (202= 2). Phlebi= tis associated with peripheral venous catheter placement: systematic review. Anatomía Digital, 5(3), 229-248. https://doi.o= rg/10.33262/anatomiadigital.v5i3.2241 &= nbsp;
<= /o:p>	&= nbsp;	ANATOMÍA DIGITAL, es una Revista Electónica, Trimestral, que se publicará en soporte electrónico tiene como misión contribuir a la formación de profesionales competentes con visión humanística y crítica que sean capaces de exponer sus resulta= dos investigativos y científicos en la misma medida que se promueva mediante = su intervención cambios positivos en la sociedad. https://anatomiadigital.org La revista es editada por la Editorial Ciencia D= igital (Editorial de prestigio registrada en la Cámara Ecuatoriana de Libro con = No de Afiliación 663) www.celibro.org.ec =
	&= nbsp;	Esta revista está protegida bajo una licencia Creative Commons AttributionNonCommercialNoDerivatives 4.0 International. Copia de la licencia: http://creativec= ommons.org/licenses/by-nc-nd/4.0/
Palabras claves: flebitis, catéter venoso, inflamación, cuidados de enfermería		Resumen El catéter venoso periférico (PVC) a menudo es una aplicación común que utilizamos para el cuidado<= span style=3D'mso-spacerun:yes'> de pacientes a nivel mundial para la administración de líquido intravenoso (IV). Objetivo: examinar en la literatura científica sobre la flebitis asociada a la colocación de catéter venoso periférico a través de la revisión sistemática. Metodología:= es una revisión bibliográfica para la realización = de este proceso, se seguirán las recomendaciones del método PRISMA. R= esultados principales: la prevalencia a n= ivel mundial de flebitis fue Australia 12%, Portugal 11,5%, Alemania 7,6%, Espańa 5,6 %, Portugal 36,7%. <= /span>Los factores de riesgo edad, sitio de venopunción, calibre de catéter venoso, intentos fallidos y medicamentos del VIH, pacientes diabéticos, fármacos inmunosupresores, sitio de venopunción, catlón número 18. Los factores de riesgo de flebitis: edad, sexo, sitio de venopunción, catéteres venosos de gran tamańo, intentos fallidos, líquidos hipertónicos antibióticos. Concl= usión: el personal deberá conocer los síntomas de flebitis, monitorear el sitio en el que se colocó la vía veno= sa periférica, la parte anatómica debe centrarse al calibre del catéter veno= so, la atención debe ser cómoda y segura logrando aumentar la calidad de esta, así se lograra evitar complicaciones como por ejemplo inflamación,
Keywords: phlebitis, venous catheter, inflammation, nursing care. &= nbsp;		Abstract= Peripheral venous catheter (PVC) is often a common application we use for patient ca= re worldwide for intravenous (IV) fluid administration. Objective: to examine the scientific literature on phlebitis associated with peripheral venous catheter placement through systematic review. Methodology: it is a literature review= for the realization of this process, the recommendations of the PRISMA method will be followed. Main results: the worldwide prevalence of phlebitis was Australia 12%, Portugal 11.5%, Germany 7.6%, Spain 5.6%, Portugal 36.7%. = Risk factors: age, venipuncture site, venous catheter size, failed attempts, a= nd HIV drugs, diabetic patients, immunosuppressive drugs, venipuncture site, cathlon number 18. Risk factors for phlebitis: age, sex, venipuncture sit= e, large venous catheters, failed attempts, hypertonic fluids, antibiotics. = Conclusion: the staff should know the symptoms of phlebitis, monitor the site where t= he peripheral venous line was placed, the anatomical part should focus on the caliber of the venous catheter, the care should be comfortable and safe, = thus increasing the quality of care and avoiding complications such as inflammation,

Introduction

The peripheral venous catheter (PVC) is often a common application t= hat we use for patient care worldwide for the administration of intravenous (IV) fluid and is used for the care of all users who come to different health ca= re facilities for the infusion of intravenous fluid and other clinical interventions (1).

The important thing is that peripheral venous catheters are an essen= tial part of nursing work, and it is a technique or procedure used to administer fluids, nutrients, drugs, or blood products, the CVP can be related to loca= l or systemic complications such as phlebitis, bacteremia or endocarditis which increases morbidity or mortality during hospital stay (2).

Phlebitis is defined as the inflammation of the venous walls whose principle has different causes, these are: chemical due to the administrati= on of irritating medications, mechanical in the puncture site, the inserted catheter can cause colonization of pathogenic agents found in the skin that migrate towards the venipuncture site (3).

This study will be novel because we will indicate what is the preval= ence worldwide with more recent data in the period 2017-2021, this study will present in examining , what is its prevalence of phlebitis, and know the ri= sk factors and what are the nursing care by reviewing scientific documents, th= is study will be focused on reviewing documents that demonstrate relevant information of phlebitis and the beneficiaries would be all who have to do = with the health area whether students, graduates, magister, doctors, specialists, postgraduates the same who will have updated information on phlebitis.=

In Spain, phlebitis is the third cause of in-hospital complications = with a prevalence of 23-54.5% of patients who present some type of vascular acce= ss. The risk factors associated with phlebitis are peripheral vascular trauma, which will depend on the size of the gill, duration, and fixation material = (4). On the other hand, in a study conducted in Portugal, the participants prese= nted a mean age of 64 years, 53.4 were women, the mean time of placement of the peripheral venous access was 3.25, the prevalence of phlebitis was 36.7% presented grade 1 phlebitis, the presence of phlebitis was associated with = the time of placement of the peripheral venous access (5).

On the other hand, a study conducted by González et al. (6), in Hava= na in the year 2018 has 2019, 11point prevalence were performed to know the us= e of peripheral venous catheter and the prevalence of the same, the study group = was 2,282 users, of which 1,087 patients had peripheral venous route was found evidence of phlebitis to 63 users it presented a prevalence of 5.8 %.<= /o:p>

The general objective is to examine the scientific literature on phlebitis associated with peripheral venous catheter placement through a systematic review.

As specific objectives we have: to identify in the scientific eviden= ce the prevalence, risk factors of phlebitis associated with peripheral venous catheter placement and to describe the main nursing care to avoid phlebitis associated with peripheral venous catheter placement.

Methodology

A bibliographic review was conducted to conduct this process, follow= ing the recommendations of the PRISMA method (7).

= Search strategy

The research was conducted through the following databases: PubMed, Scopus, ProQuest in the period 2016 and 2021. Those related to the topic wi= th phlebitis associated with peripheral venous catheter placement, incidences, types, risk factors and nursing care, keywords related to the desired objectives, according to the Mesh and DeCS terms: phlebitis, venous cathete= r, inflammation, nursing care, the connections of these with Boolean connectors "AND" and "OR" were selected. After a first search, each article will be reviewed according to title and abstract, those that had the description of the clinical variables and that exposed phlebitis associated with peripheral venous catheter placement will be included. However, in tho= se cases in which the study methodology was not clear and the results were not= very precise, the article will be excluded.

= Inclusion Criteria

The selected articles must meet the following parameters<= /span>

· Year of publication: between 2016 and 2021. <= /o:p>

· Studies conducted in phlebitis associated with peripheral venous catheter placement.

· Quality of the articles.

· High impact papers.

= Exclusion criteria

· Letters to the editor.

· Impossibility to retrieve the full text of the article.

· Repeated article from a previous search.

= Processing

The data obtained were summarized in tables, in which phlebitis associated with peripheral venous catheter placement was presented. The following steps were followed, in the first stage, the topic and the formulation of the research question were identified through the strategy Prevalence or incidence /PEO (Population, e= xposure and observation), In the second stage, the inclusion/exclusion criteria were applied. In the third stage, an in-depth document review was conducted. In = the fourth stage, the synthesis of documents was conducted for the elaboration = of results and discussion.

Results

Figure 1.

Flow diagram.

PubMed: 7

Scopus: 12

ProQuest: 11

=

Literature review (n=3D15) Duplicates: 4

IDENTIFICATION

SELECTION

ELIGIBILITY

INCLUSION

Record of selected documents (n=3D150)=

Exclusion: (n=3D 100)

Exclusion of articles that did not correspond to the study by reading abstracts. (n=3D121)<= span lang=3DEN-US style=3D'font-size:10.0pt;font-family:"Times New R= oman",serif; mso-fareast-font-family:"Times New Roman";color:black;mso-ansi-= language: EN-US'>

= Selected studies for complete reading

= Excluded studies (n=3D19)

<= span lang=3DEN-US style=3D'font-size:10.0pt;line-height:115%;font-fami= ly:"Times New Roman",serif; mso-ansi-language:EN-US'>Completed studies evaluated for eligibil= ity (n=3D40)

<= span lang=3DEN-US style=3D'font-size:10.0pt;line-height:115%;font-fami= ly:"Times New Roman",serif; mso-ansi-language:EN-US'>Complete studies excluded (n=3D 9)<= /o:p>

<= span lang=3DEN-US style=3D'font-size:10.0pt;mso-bidi-font-size:9.0pt; line-height:115%;font-family:"Times New Roman",serif;mso-ansi-lan= guage: EN-US'>Studies included in the final sample (n=3D 31)<= /span>

Table 1.

Selected articles are orde= red as follows: authors, year of publication, title, city, prevalence, risk fac= tors and the nursing process.

Author

Year

Title<= /b>

Country

Prevalence

Risk Factors<= /span>

Nursing care<= /span>

Marsh et al.= (8)

2021

Periphe= ral intravenous catheter failure: a secondary risk analysis=

Austral= ia

12%

&n= bsp;

---

---

Luyu & J= iaquin (9)

2020

The incidence and risk of phlebitis from intravenous catheter

infusion with peripheral intravenous

periphe= ral intravenous catheters: a meta-analysis

Portugal

11,5

---

---

Seven et al. (10)

2019

Point prevalence survey of peripheral venous catheter use in a large tertiary c= are university hospital in Germany.

Germany

33%

---

---

Larsen et al. (11)

2020

Inherent and modifiable risk factors for peripheral venous catheter failure during cancer treatment: a prospective cohort study.

Germany

7,6%

---

---

Table 1.

Selected artic= les are ordered as follows: authors, year of publication, title, city, prevalen= ce, risk factors and the nursing process. (continued)

Author

Year

Title

Country

Prevalence

Risk Factors

Nursing care

Arias &<= /span> Suerez (12)

2017

Inciden= ce and risk factors of peripheral intravenous catheter-associated phlebitis<= o:p>

Spain

5,6%

---

---

Annisa & Nurhaeni (27)

2017

Warm wa= ter compresses as an alternative to reduce the degree of phlebitis=

Indonesian

---

---

They received 0.9% NaCl compresses and those who received 0.9% NaCl received warm water compresses

Santa Ana et= al. (19)

2019

Patient safety in the context of reported notifications in a reported in a univer= sity hospital

Brazil

---

Age and sex.

---

Braga et al.= (20)

2018

Phlebit= is and infiltration: vascular trauma associated with the peripheral venous c= atheter

Brazil

---

Age, venipuncture site, venous catheter caliber, failed attempts, and medicati= ons.

---

Munabshe &am= p; Mukona (21)

2018

Factors Contributing to Phlebitis in Adult Patients Admitted to patients admitted= to the medical-surgical units of a central hospital in Harare, Zimbabwe.

Africa

---

Male gender, HIV, diabetic patients, immunosuppressive drugs, venipuncture sit= e, catlon number 18.

---

Table 1.

Selected artic= les are ordered as follows: authors, year of publication, title, city, prevalen= ce, risk factors and the nursing process. (continued)

Author

Year

Title

Country

Prevalence

Risk Factors

Nursing care

Hong (22)

2020

Develop= ment and Effectiveness of the Intravenous Infusion Evidence-Based Nursing Prac= tice Guideline Practice Implementation Program - for Small and Medium Hospital= s.

Brazil

---

---

The lon= ger the care time, the lower the probability of the presence of phlebitis in = the patient, according to this research.

Pires & Silva (13)

2018

Prevale= nce of phlebitis associated with peripheral intravenous catheter

cathete= r-associated phlebitis: associated factors

Portugal

36.7 %<= o:p>

---

---

Liu et al. (= 15)

2020

Inciden= ce, risk factors and medical cost of peripheral intravenous catheter-related complications in hospitalized adult patients.

China

10,5 %<= o:p>

---

---

Table 1.

Selected artic= les are ordered as follows: authors, year of publication, title, city, prevalen= ce, risk factors and the nursing process. (continued)

Author

Year

Title

Country

Prevalence

Risk Factors

Nursing care

Lee & Ki= m (14)

2019

A model= of peripheral intravenous catheter-associated phlebitis in hospitalized orthopedic patients

Brazil

35,9 % =

---

---

Umma & M= ohammad (16)

2019

Frequen= cy of peripheral intravenous catheter-related phlebitis

and rel= ated risk factors: a prospective study.

India

18.09 %= of grade 1 and 2

Infusio= n of hypertonic liquids and certain antibiotics such as: amikacin, meropenem, amoxicillin, clavulanic acid, flucloxacillin.

---

Abilo et al. (23)

2021

Inciden= ce of intravenous catheter phlebitis and its associated

periphe= ral catheter phlebitis and its associated factors among

patients admitted to Gondar University

Gondar University Hospital, northwestern Ethiopia.

Ethiopia

-----

Age, gender, residence, religion, admission diagnosis, school education, time = of peripheral venous catheter insertion, intravenous drugs.

-----

Table 1.

Selected artic= les are ordered as follows: authors, year of publication, title, city, prevalen= ce, risk factors and the nursing process. (continued)

Author

Year

Title

Country

Prevalence

Risk Factors<= span lang=3DEN-US style=3D'font-size:10.0pt;line-height:115%;font-family:"Time= s New Roman",serif; mso-ansi-language:EN-US'>

Nursing care

Salguero et = al. (28)

2019

Nursing= practice in peripheral venous catheterization: phlebitis and patient safety.<= /o:p>

Portugal

---

---

Select = the anatomical site for venipuncture, select the venous catheter caliber, per= form hand hygiene and disinfection of materials, properly cannulate, and secure the venous catheter, educate to involve the patient in venous catheter ca= re.

Pinto & = Cruz (29)

2017

Indicat= ors for the evaluation of nursing care: a descriptive-exploratory study.=

Brazil

----

------

Know hardening of the venous tract i.e., varicose veins, redness of the affect= ed area, sensation of pain, fever, or discomfort if infection is present.

Abhiyit (24)=

2019

Study of the incidence of phlebitis after the use of peripheral intravenous cathet= er.

India

------

These w= ere female sex, age less than 60 years, large venous catheters, venous lines placed in emergent situations, administration of medications.<= /span>

----

Table 1.

Selected artic= les are ordered as follows: authors, year of publication, title, city, prevalen= ce, risk factors and the nursing process. (continued)

Author

Year

Title

Country

Prevalence

Risk Factors<= span lang=3DEN-US style=3D'font-size:10.0pt;line-height:115%;font-family:"Time= s New Roman",serif; mso-ansi-language:EN-US'>

Nursing care

Wen & Yo= u (30)

2018

Occurre= nce of phlebitis

Taiwan

----

----

The sta= ff should monitor the site where the peripheral venous line was placed, the anatomical part should focus on the caliber of the venous catheter, the c= are should be comfortable and safe, thus increasing the quality of care and avoiding complications such as inflammation, obstruction of the peripheral venous catheter, suppuration.

Bherulal &am= p; Musurrat (18)

2020

Factors contributing to phlebitis in patients admitted to third level medical-surgical units.

France

Prevale= nce of 26 % in the medical areas while in the operating rooms it was 10.2 %.<= o:p>

&n= bsp;

&n= bsp;

Table 1.

Selected artic= les are ordered as follows: authors, year of publication, title, city, prevalen= ce, risk factors and the nursing process. (continued)

Author

Year

Title

Country

Prevalence

Risk Factors

Nursing care<= span lang=3DEN-US style=3D'font-size:10.0pt;line-height:115%;font-family:"Time= s New Roman",serif; mso-ansi-language:EN-US'>

Chen & Xiao<= span lang=3DEN-US style=3D'font-size:12.0pt;mso-bidi-font-size:11.0pt;line-hei= ght: 115%;font-family:"Times New Roman",serif;mso-ansi-language:EN-US'> (25)

2021

Evaluation of risk factors in time for phlebitis= and non-phlebitis related failures when peripheral venous catheters are phleb= itis when peripheral venous catheters were replaced as clinically replaced as clinically indicated

Turkey

----

Risk factors were antibiotics such as intravenous flucloxacillin, female gende= r, site of insertion of the venous line in the dominant hand

----

Chen et al. = (26)

2021

Risk factors for peripheral venous catheter failure: a prospective cohort stud= y of 5345 patients.

China

---

They were fluid leakage, age over 60-74 years ol= d, emergency area, poor cannulation practice, administration of irritating fluids, insertion time.

---

Anayanci (31= )

2020

Phlebit= is: Basic knowledge for nurses

Mexico

---

----

Scientific knowledge of definition, signs and symptoms and nursing performance, using the assessment scale depending on each institution, your diagnosis will be issued to provide your treatment= .

Table 1.

Selected artic= les are ordered as follows: authors, year of publication, title, city, prevalen= ce, risk factors and the nursing process. (continued)

Author

Year

Title

Country

Prevalence

Risk Factors<= span lang=3DEN-US style=3D'font-size:10.0pt;line-height:115%;font-family:"Time= s New Roman",serif; mso-ansi-language:EN-US'>

Nursing care<= span lang=3DEN-US style=3D'font-size:10.0pt;line-height:115%;font-family:"Time= s New Roman",serif; mso-ansi-language:EN-US'>

Altamirano e= t al. (17)

2018

Phlebit= is and pressure ulcers in nursing care, in the

Esmeral= das Hospital

Ecuador

5,67%

----

----

Discussion

For the analysis we select= ed thirty-one articles that helped us answer our research questions about prevalence of phlebitis, risk factors, and nursing care.

= Prevalence of phlebitis worldwide

In a study conducted in Australian metropolitan and regional hospita= ls in the hematology, oncology and operating room medical units, the prevalenc= e of phlebitis was 12% (8). On the other hand, a study conducted in Portugal sho= wed a prevalence of phlebitis of 11.5% in 110 patients with a CVP (9). In a stu= dy conducted in Germany in a third level hospital, the prevalence of phlebitis was 33% (= 10).

A research work conducted by Larsen et al. (11), in Germany showed a prevalence of phlebitis of 7.6%. Likewise, another study conducted in Spain= by nursing personnel showed a prevalence of phlebitis of 5.6% (12).

A study conducted in Portugal by Pires & Silva (13), showed a prevalence of phlebitis of 36.7%, which is why it was recommended to reduce= the permanence of the peripheral venous line according to the protocols of each institution. According to one study, the prevalence of phlebitis was 35.9% = in a hospital in Brazil (14). On the other hand, a study conducted in China by L= iu et al. (15), the prevalence of phlebitis was 10.5% in a University Hospital= .

In India, the prevalence of phlebitis was 18.09 of grade 1 and 2 (16). A study conducted in Ecuador in a Hospital in Esmeraldas, the prevalence of phlebitis was 5.7%, that is, thir= ty-two persons (17). A study conducted in France by Bherulal & Musurrat (18), = was studied in a tertiary care center in surgical units and medical units with = a prevalence of 26% in the medical areas while in the surgical wards it was 10.2%.<= /o:p>

=

= Risk factors associated with phlebitis

In a study conducted by Santa Ana et al. (19), in a Brazilian hospit= al, the risk factors were age and sex. Another study conducted in Brazil by Bra= ga et al. (20), the risk factors were age, venipuncture site, venous catheter caliber, failed attempts, and medications in a study group of 110 patients = as a sample.

Likewise, a study conducted in Africa by Munabshe & Mukona (21), identified the following factors: male gender, HIV, diabetic patients, immunosuppressive drugs, venipuncture site, catheter number 18.<= /span>

The risk factors showed that the higher the ratio of hours, the lower the incidence of phlebitis (22). In a study conducted in India, the most prevalent risk factors were infusion of hypertonic liquids and certain antibiotics such as: amikacin, meropenem, amoxicillin, clavulanic acid, flucloxacillin (16).

In a study conducted in Ethiopia, the risk factors for the appearanc= e of phlebitis were age, gender, residence, religion, admission diagnosis, school education level, time of having a peripheral venous catheter inserted, intravenous drugs (23).

A study conducted in a military hospital in India, the risk factors = were female sex, age under 60 years, large venous catheters, venous lines placed= in emergent situations, administration of drugs (24).

Chen & Xiao (25), risk factors in a hospital study were age over= 65 years, male gender, difficult access veins, anatomical site at the level of= the forearm and dorsum of the hand, Teflon catheter 18, 20, 22 imported from New Jersey, United States, poor technique, perfusion solution other than sodium chloride, time of fixation of lines.

The risk factors in a study conducted in a third level hospital in C= hina were fluid leakage, age over 60-74 years old, emergency area, poor cannulat= ion practice, administration of irritant fluids, insertion time (26).

Conclusions

·         It is concluded with this systema= tic review that the prevalence of phlebitis worldwide is high in certain countr= ies, nurses should put more emphasis when performing this procedure: Australia 1= 2%, Portugal 11.5%, Germany 33%, Spain 5.6%, Portugal 36.7%, Brazil 35.9%, China 10.5%, India 18.09, Esmeraldas 5.7%. The nursing staff should have the tech= nique, practice, and knowledge for a prompt action of phlebitis to stop complicati= ons that may occur.

·         According to this study, the risk factors for phlebitis were age, sex, venipuncture site, large venous cathet= ers, failed attempts, medications, hypertonic liquids, antibiotics such as: amikacin, meropenem, amoxicillin, clavulanic acid, flucloxacillin, emergency area, anatomical site at the level of the forearm and dorsum of the hand, a= nd the presence of a venous catheter.

·         The nursing care according to the= realization of this systematic review the staff should know the symptoms of phlebitis, monitor the site where the peripheral venous line was placed, the anatomical part should focus on the caliber of the venous catheter, the care should be comfortable and safe achieving increase the quality of the same, thus avoid= ing complications such as inflammation, treatment can sodium chloride (Na Cl), = warm water painkillers if appropriate.

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Conflict of interest<= /o:p>

There is no conflict of interest on the part of the investigators.

El artíc= ulo que se publica es de exclusiva responsabilidad de los autores y no necesariamente reflejan el pensamiento de la Revista Anatomía Digital.

El artículo queda en propiedad de la revista y, por tanto, su publicación parc= ial y/o total en otro medio tiene que ser autorizado por el director de la R= evista Anatomía Digital.

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Author	Year	Title<= /b>	Country	Prevalence	Risk Factors<= /span>	Nursing care<= /span>
Marsh et al.= (8)	2021	Periphe= ral intravenous catheter failure: a secondary risk analysis=	Austral= ia	12% &n= bsp;	---	---
Luyu & J= iaquin (9)	2020	The incidence and risk of phlebitis from intravenous catheter infusion with peripheral intravenous periphe= ral intravenous catheters: a meta-analysis	Portugal	11,5	---	---
Seven et al. (10)	2019	Point prevalence survey of peripheral venous catheter use in a large tertiary c= are university hospital in Germany.	Germany	33%	---	---
Larsen et al. (11)	2020	Inherent and modifiable risk factors for peripheral venous catheter failure during cancer treatment: a prospective cohort study.	Germany	7,6%	---	---

Author	Year	Title	Country	Prevalence	Risk Factors	Nursing care
Arias &<= /span> Suerez (12)	2017	Inciden= ce and risk factors of peripheral intravenous catheter-associated phlebitis<= o:p>	Spain	5,6%	---	---
Annisa & Nurhaeni (27)	2017	Warm wa= ter compresses as an alternative to reduce the degree of phlebitis=	Indonesian	---	---	They received 0.9% NaCl compresses and those who received 0.9% NaCl received warm water compresses
Santa Ana et= al. (19)	2019	Patient safety in the context of reported notifications in a reported in a univer= sity hospital	Brazil	---	Age and sex.	---
Braga et al.= (20)	2018	Phlebit= is and infiltration: vascular trauma associated with the peripheral venous c= atheter	Brazil	---	Age, venipuncture site, venous catheter caliber, failed attempts, and medicati= ons.	---
Munabshe &am= p; Mukona (21)	2018	Factors Contributing to Phlebitis in Adult Patients Admitted to patients admitted= to the medical-surgical units of a central hospital in Harare, Zimbabwe.	Africa	---	Male gender, HIV, diabetic patients, immunosuppressive drugs, venipuncture sit= e, catlon number 18.	---