Visual evaluation of the central venous catheter's exit site in hemodialysis: preliminary validation of an Italian scale

Abstract

The central venous catheter (CVC) represents an alternative to the arteriovenous fistula (AVF) for patients on hemodialysis. However, CVCs are often cause of a large number of infective complications. Since nurses are the first healthcare professionals who detect possible infections, it is important to develop a visual scale to help their evaluation. This type of scale is important also for new nurses, as a way to take into consideration the main indicators of a possible CVC infection. Finally, this scale may be helpful to trace the evolution of a patient’s CVC in his medical record. This study presents the first validation of an Italian scale that is used for the evaluation of CVC exit sites in hemodialysis. This scale is derived from the “Twardoski Scale”. The validation involved the nurses of a Network of Nephrology and Dialysis, and an external nurse; the latter was not involved in the care of CVCs, and evaluated the exit site of the patients of the Network before the scale-aided evaluation by the nurse who took care of the CVC. The good Spearman correlation (ρ=0.85) between the assessment of the external nurse and that of her colleagues confirms the goodness of the first Italian translation of the scale. (nursing)