A Comparative Study of Accuracy and Usability between Two Extravasation Injuries Assessment Tools

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Thitiporn Pathomjaruwat
Wongchan Petpichetchian
Padcha Pongcharoen

Abstract

Extravasation injury is the severe complication of infusion therapy and requires nurses to assess and manage it appropriately. This comparative study was aimed to determine the accuracy and usability of two extravasation injuries assessment tools.  The participants were 50 nurses from a tertiary hospital. Each nurse was asked to review two parallel sets of photos (72 photos/set) and assessed for occurrence and the severity of extravasation injuries using the following tools: (A) Extravasation Assessment Tool and (B) Extravasation Scale. Photos taken from 72 patients who had normal condition (no extravasation) and three severity levels: mild, moderate, and severe extravasation (18 photos/condition/set) were used. Using the known diagnosis of extravasation injury of these patients made by trained dermatologists as a reference standard, the accuracy of these tools when used by nurses were determined. There were 3600 observed data for each tool (50 nurses*72 photos/tool). It was revealed that use of the Extravasation Assessment Tool and the Extravasation Scale produced 2,898 (80.5%) and 3,386 (94.1%) accurate results, respectively with  a significant difference in number of defectives or inaccurate ratings (13.6%, 99% upper bound = 11.77, p < .001). The sensitivity and specificity of the Extravasation Scale were 0.96 and 0.88, respectively. The usability of the tools were compared and found that the Extravasation Scale was more usable as indicated by more nurses being satisfied and very satisfied, less nurses requiring consultation and less time consuming. These results supported that the Extravasation Scale could be used to accurately assess the occurrence and severity of extravasation injuries better than the Extravasation Assessment Tool. Nurses should use this tool to help identify its occurrence and severity in clinical practice. It would be helpful to early detect and promptly manage extravasation injuries.

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1.
Pathomjaruwat T, Petpichetchian W, Pongcharoen P. A Comparative Study of Accuracy and Usability between Two Extravasation Injuries Assessment Tools. PRIJNR [Internet]. 2021Jun.15 [cited 2021Sep.27];25(3):437-51. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/249086
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