The development and validation of a chemotherapy induced chemical phlebitis severity scale

Meinir Hughes, Rosemary Roberts, Gina Dolan, Edgar Williams

Research output: Chapter in Book/Report/Conference proceedingConference contributionpeer-review


Purpose: Chemotherapy administered by peripheral intravenous cannulation can induce chemical phlebitis with symptoms affecting a patient’s quality of life. While other chemotherapy toxicities are accurately graded it was identified that there is no suitable scale designed to assess and grade chemotherapy-induced phlebitis. A phlebitis severity scoring tool that is specific for chemotherapy-induced phlebitis was developed and validated with breast cancer patients receiving anthracycline chemotherapy.

Methods: A cross-sectional survey was conducted on breast cancer patients attending chemotherapy appointments. The patients answered questions on any pain associated with chemotherapy administration and their arms examined for signs of phlebitis (redness, swelling, tethering, a palpable venous cord, vein discolouration, and impaired arm function), which formed the chemotherapy induced phlebitis severity (CIPS) scale. Two nurse assessors made independent assessments 5 minutes apart.

Results: In total, 207 patients completed the two assessments while developing eight versions of the CIPS scale. A five-scale scoring tool was developed (CIPS-V8) and tested on 121 patients, agreement between each pair of assessors was very good, with 106/121, 86.9% the same (k=0.82, SE ± 0.042, 95%CI 0.74 – 0.90). The CIPS scale took about 1.5 minutes to complete with patients with symptom grade two taking longest.

Conclusions: The CIPS scale provides a list of symptoms associated with chemotherapy phlebitis which can be scored quickly and accurately by an experienced nurse. Multicentre testing of CIPS is recommended.

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Marsh N, Mihala G, Ray‐Barruel G et al (2015) Inter‐rater agreement on PIVC‐associated phlebitis signs, symptoms and scales. Journal of Evaluation in Clinical Practice. 21, 5, 893-899.

Ray-Barruel G, Marsh N, Mihala G, Rickard C (2014) o-009: inter-rater Agreement Of Phlebitis Assessment Symptoms And
Scales. The Journal of Vascular Access. 15, 3, 195-196.
Original languageEnglish
Title of host publicationThe UK Oncology Nursing Society Annual Conference 2018 Abstract Book
Number of pages1
Publication statusPublished - 16 Nov 2018
EventUK Oncology Nursing Society Annual Conference 2018: Crossing boundaries in cancer care - Scottish Event Campus (SEC), Glasgow, United Kingdom
Duration: 16 Nov 201817 Nov 2018


ConferenceUK Oncology Nursing Society Annual Conference 2018
Abbreviated titleUKONS2018
Country/TerritoryUnited Kingdom
Internet address


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