Effects of Standardized Patient and In Situ Simulation on Nursing Students' Peripheral Intravenous Catheter-Related Infiltration Recognition and Clinical Decision-Making: A Randomized Controlled Trial

Peripheral intravenous catheter (PIVC) cannulation is a widely used method for vascular access and is considered one of the most common invasive procedures performed in hospitalized patients. This technique provides rapid access to the vascular system due to being less invasive and less complex compared to alternative methods. The type of catheter is selected based on the estimated duration and type of therapy, and PIVCs are commonly used for fluid therapy, parenteral nutrition, administration of blood products, and diagnostic procedures.

Phlebitis, one of the most common complications associated with PIVCs, may develop not only during catheterization but also within 24-96 hours after catheter removal. The incidence of PIVC-related phlebitis varies widely in the literature, ranging from 1.5% to 80%. Phlebitis is defined as acute inflammation of the venous wall resulting from irritation of the vascular endothelium at or near the catheter insertion site. Its identification requires the assessment of clinical signs and symptoms at the insertion site, including erythema, swelling along the vein, pain, warmth, and, in some cases, fever.

It is estimated that complications related to PIVCs are more extensive than currently reported, with approximately 70-90% of patients experiencing complications that may prolong hospital stays by up to 22 days. These complications negatively affect patient comfort, contribute to unnecessary diagnostic and therapeutic interventions, delay treatment, increase healthcare costs, elevate patient stress, and increase the workload of healthcare professionals.

In this context, early recognition of phlebitis and the development of clinical decision-making skills among nursing students are critical for ensuring patient safety. Traditional educational approaches that focus primarily on the transfer of theoretical knowledge are increasingly insufficient for preparing students to manage complex clinical situations. Therefore, there is a growing need for realistic, interactive, and learner-centered educational strategies that support early diagnosis and appropriate clinical decision-making. Innovative teaching methods that promote active student engagement and provide opportunities to experience clinical situations in a safe environment play a strategic role in developing these essential competencies.

One such innovative approach is video-based learning, which has emerged as a powerful educational tool by providing a dynamic and engaging platform for content delivery. Video-based learning refers to the acquisition of knowledge and skills through video materials and encompasses various strategies designed to enhance student engagement and learning outcomes, particularly in fields such as healthcare education where practical skills are essential. In addition to being learner-centered, video-based learning offers advantages such as increased engagement, accessibility, and flexibility. These benefits highlight the need for more comprehensive and experiential learning environments in which learners move beyond passive observation to actively interpret clinical contexts and mentally rehearse decision-making processes.