[en] The management of peripheral venous catheters (PVCs) is a nursing competence. While the use of PVCs is extensive in the hospital setting, patients are not exempt from complications. Hospital protocols or guidelines on the management of PVCs with respect to PVC-related phlebitis are heterogeneous, nursing knowledge is limited, and the application of evidence-based practice is scarce. The general objectives of this thesis are: 1) To determine the evolution of scientific production and trends on vascular access and phlebitis due to peripheral venous catheterization; and 2) To identify and reach a consensus on PVC management in relation to phlebitis in the healthcare context. Different research methodologies were used with respect to the objectives that were set. Two analytical and descriptive bibliometric analyzes and two expert-based Delphi studies were carried out, at national and international level, to reach a consensus and evaluate PVC management. The international study also included semi-structured interviews with experts. This thesis presents 4 articles in the results section. The bibliometric studies (N= 995 articles and N=1596 articles) revealed a prolonged and sustained interest in venous access and the issue of infections and other complications, as well as the need for monitoring and surveillance by nurses. Areas to be explored in relation to phlebitis were also identified as the basis for consensus studies, as well as emerging areas of study. The national Delphi study included 27 expert nurses and the international study 18 multidisciplinary experts. 4 of whom were interviewed to complement the information obtained. In both studies, activities were prioritized according to importance along three dimensions: Assessment, Treatment and Monitoring. As a synthesis of the thesis, it should be noted that while widely varying criteria and interventions for the management of phlebitis were found, the results of the studies undertaken highlight the importance of the following aspects in the management of PVC-related phlebitis: systematic assessment tools, treatment selection according to severity, the importance of daily visual monitoring and recording, the need for patient participation. Also emerging are the benefits of interdisciplinary work and specialist vascular access teams, and the use of evidence-based practice. Despite the increase in publications, especially internationally, more research is needed to address complications and optimize the management of CVP, given the impact on the quality of care and patient safety.

[es] El manejo de los catéteres venosos periféricos (CVP) es una competencia enfermera. El uso de los CVPs es extenso en el medio hospitalario, pero los pacientes no están exentos de complicaciones. Los protocolos o guías de los centros hospitalarios sobre el manejo de los CVP en relación con la flebitis por CVP son heterogéneos, el conocimiento enfermero es limitado y la aplicación de la práctica basada en la evidencia (PBE) es escasa. Los objetivos generales de esta tesis son dos: 1) Determinar la evolución de la producción científica y tendencias sobre acceso vascular y flebitis por cateterismo venoso periférico, y 2) Identificar y consensuar el manejo de los catéteres venosos periféricos en relación con la flebitis en el contexto asistencial. Se han utilizado diferentes metodologías de investigación para dar respuesta a los objetivos planteados. Se realizaron dos análisis bibliométricos analíticos y descriptivos, y dos estudios Delphi, de ámbito nacional e internacional para consensuar y valorar entre expertos el manejo de los CVP. El estudio internacional también incluye entrevistas semiestructuradas a los/las expertos/as. Esta tesis presenta en el apartado de resultados 4 artículos. Los estudios bibliométricos (N= 995 artículos y N=1596 artículos) establecieron un interés mantenido en el tiempo sobre el acceso venoso relacionado con el tema de las infecciones y otras complicaciones, y la necesidad de control y vigilancia por parte de enfermería. También se detectaron las áreas a explorar en relación con la flebitis que sirvieron de base para los estudios de consenso y las áreas de estudio emergentes. El estudio Delphi de ámbito nacional incluyó a 27 enfermeras expertas y el internacional 18 expertos multidisciplinares y 4 fueron entrevistados para complementar la información obtenida. En ambos estudios se priorizaron las actividades en función de su importancia en tres dimensiones: Valoración, Tratamiento y Monitorización. A modo de síntesis, cabe detallar que existe gran variabilidad de criterios e intervenciones para el manejo de la flebitis. Se destaca la importancia de herramientas de valoración sistemática, escoger tratamiento según gravedad, y la importancia del registro y seguimiento visual diario; junto con la necesidad de participación del paciente. Emergen las bondades del trabajo interdisciplinario y equipos especializados en acceso vascular, más una PBE para el manejo de los CVP. A pesar del aumento de publicaciones, es clave más investigación, dado el impacto en la calidad de los cuidados y la seguridad del paciente.