Development and validation of a Vein Assessment Tool (VAT).

OBJECTIVE To assess the face validity and the inter-rater reliability of the Vein Assessment Tool (VAT) for classifying veins according to their level of intravenous insertion difficulty. DESIGN Prospective observational study. PARTICIPANTS Eight nurses and two radiographers from the Medical Imaging Department and five nurses from the Haematology Day Patient Unit of a large tertiary hospital. INTERVENTION Assessments of veins in the upper limb were undertaken independently by nurses from two departments of a major tertiary hospital. MAIN OUTCOME MEASURE Level of inter-rater agreement assessed using intraclass correlation coefficients (ICC). RESULTS A total of 125 independent assessments were made by 15 nurses. The mean percentage agreement between raters from Medical Imaging was 84% (SD 10.7; range 60% to 100%) and between raters from Oncology was 92% (SD 17.9; range 60% to 100%). The inter-rater reliability was very high for the ten medical imaging raters 0.83 (95% confidence interval CI = 0.61 - 0.95) and for the Oncology raters 0.93 (95% CI = 0.77-0.99). CONCLUSION The Vein Assessment Tool (VAT) has been validated by a sample of nurses with cannulating experience. Following broader testing it may be useful for research studies or by nurses who wish to objectively describe the condition of a vein for clinical purposes.