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Original research
The I-DECIDED clinical decision-making tool for peripheral intravenous catheter assessment and safe removal: a clinimetric evaluation
  1. Gillian Ray-Barruel1,2,
  2. Marie Cooke1,
  3. Vineet Chopra3,4,
  4. Marion Mitchell1,
  5. Claire M Rickard1,5
  1. 1Alliance for Vascular Access Teaching and Research, Menzies Health Institute Queensland, School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
  2. 2Nursing Research, Queen Elizabeth II Jubilee Hospital, Princess Alexandra Hospital, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
  3. 3Division of Hospital Medicine, Patient Safety Enhancement Program, University of Michigan, Ann Arbor, Michigan, USA
  4. 4Center for Clinical Management Research, Ann Arbor VA Medical Center, Ann Arbor, Michigan, USA
  5. 5Nursing Research & Development, and Critical Care Research Group, Royal Brisbane & Women's Hospital, Princess Alexandra Hospital, The Prince Charles Hospital, Brisbane, Queensland, Australia
  1. Correspondence to Dr Gillian Ray-Barruel; g.ray-barruel{at}


Objective To describe the clinimetric validation of the I-DECIDED tool for peripheral intravenous catheter assessment and decision-making.

Design and setting I-DECIDED is an eight-step tool derived from international vascular access guidelines into a structured mnemonic for device assessment and decision-making. The clinimetric evaluation process was conducted in three distinct phases.

Methods Initial face validity was confirmed with a vascular access working group. Next, content validity testing was conducted via online survey with vascular access experts and clinicians from Australia, the UK, the USA and Canada. Finally, inter-rater reliability was conducted between 34 pairs of assessors for a total of 68 peripheral intravenous catheter (PIVC) assessments. Assessments were timed to ensure feasibility, and the second rater was blinded to the first’s findings. Content validity index (CVI), mean item-level CVI (I-CVI), internal consistency, mean proportion of agreement, observed and expected inter-rater agreements, and prevalence-adjusted bias-adjusted kappas (PABAK) were calculated. Ethics approvals were obtained from university and hospital ethics committees.

Results The I-DECIDED tool demonstrated strong content validity among international vascular access experts (n=7; mean I-CVI=0.91; mean proportion of agreement=0.91) and clinicians (n=11; mean I-CVI=0.93; mean proportion of agreement=0.94), and high inter-rater reliability in seven adult medical-surgical wards of three Australian hospitals. Overall, inter-rater reliability was 87.13%, with PABAK for each principle ranging from 0.5882 (‘patient education’) to 1.0000 (‘document the decision’). Time to complete assessments averaged 2 min, and nurse-reported acceptability was high.

Conclusion This is the first comprehensive, evidence-based, valid and reliable PIVC assessment and decision tool. We recommend studies to evaluate the outcome of implementing this tool in clinical practice.

Trial registration number 12617000067370

  • assessment, intravenous
  • intravenous catheter, peripheral
  • decision-making
  • reliability
  • validity
  • measurement

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  • Twitter @graybarruel, @claire_avatar

  • Contributors GR-B conceived and developed the I-DECIDED tool. GR-B, MC, VC, MM and CMR conceived the study concept and contributed to the design. GR-B acquired, analysed and interpreted the data, and wrote the first draft. MC, VC, MM and CMR provided critical review and intellectual input. All authors read and approved the final version of the manuscript and take public responsibility for its content.

  • Funding Financial support for this study was provided in part by grants from Griffith University and the Australian College of Infection Prevention and Control. The funding agreements ensured the authors’ independence in designing the study, interpreting the data, writing, and publishing the report. The following authors are employed by the sponsor, Griffith University: Gillian Ray-Barruel, Marie Cooke, Marion Mitchell, Claire M Rickard. A video of the I-DECIDED ® device assessment and decision tool is available:

  • Competing interests Griffith University has received on GRB’s behalf unrestricted research grants (3M and Becton Dickinson) and consultancy payments (Ausmed, 3M, BD, Medline, and Wolters Kluwer). MC has received investigator-initiated research and educational grants and speaker fees provided to Griffith University by vascular access product manufacturers (Baxter, BD, Entrotech Life Sciences). VC receives funding from the Veterans Health Administration, National Institute for Health, Agency for Healthcare Research and Quality, and Centers for Disease Control. MM: No conflicts of interest. CMR: Griffith University has received on CMR’s behalf unrestricted investigator‐initiated research or educational grants from product manufacturers (3M, AngioDynamics; BD-Bard, Baxter; BBraun, Cardinal Health, Medtronic, Smiths Medical); and consultancy payments (3M, BD-Bard; BBraun, ResQDevices, Smiths Medical). No commercial entity had any role in the design or undertaking of this study.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. All data relevant to the study are included in the article or uploaded as supplementary information.

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