This blog post draws primarily on an article published in a Finnish specialist magazine issued by the national infection‑control society.¹
Peripheral venous cannulas come with an inherent infection risk. The VIP Score can support the early detection of complications. In the Finnish healthcare organisation, Kymenlaakso wellbeing services county, the VIP Score has been brought into the Medanets mobile app. This has significantly enhanced the monitoring of cannulation sites and the documentation of clinical findings.
VIP Score – An evidence-based approach
Because peripheral venous cannulas can lead to infection, the condition of the skin around the cannula site should be assessed once per shift.² The Visual Infusion Phlebitis (VIP) Score is an evidence-based, three- or five-point scale designed to support this assessment.³ The three-point scale is generally applied as follows²,⁴:
- The skin around the cannula looks healthy → clinician documents the observation and continues monitoring once per shift.
- Mild redness and/or pain near the cannula → clinician relocates the cannula, informs the doctor of a possible infection, documents the finding in the EHR, continues to monitor the redness, and files a healthcare-associated infection report.
- Red, painful, swollen, exuding or clearly infected cannula site → clinician relocates the cannula, informs the doctor, documents the finding, takes a bacterial culture from any exudate, takes blood cultures if the patient is febrile, and files a healthcare-associated infection report.
Monitoring cannula sites in the Kymenlaakso wellbeing services county
In Kymenlaakso, staff have always monitored the skin around IV cannulas as part of routine care. Although overall infection rates had been relatively low in recent years, the organisation aimed to further develop and standardise monitoring practices to improve documentation, maintain high quality of care, and enhance patient safety. There was room for further progress in the systematic documentation of observations from cannula sites. Infection surveillance relied largely on a reporting system triggered by the initiation of antibiotic treatment, meaning that some infections may have gone undocumented.
In 2024, work began to standardise practice, with the VIP Score adopted as a key tool. Staff on two medical wards received training and practised documenting VIP Score findings directly in the EHR system for nine months. However, many still found the process cumbersome, and there was no clear improvement in infection reports or documentation volume. Nevertheless, awareness among staff increased, and the VIP Score itself was welcomed – what was needed was a faster and easier way to document the findings.
The breakthrough came when the VIP Score was added to Medanets, the mobile app already widely used within the organisation. Documentation and monitoring increased immediately. Today, infections are tracked far more systematically and can be addressed earlier. Work to refine the process – especially reporting – continues.
How their model works in practice:
- The VIP Score is available directly in the Medanets mobile app.
- Clinicians assess the cannula site using the three-point scale.
- A numerical VIP Score is entered via the app.
- Additional details – such as cannula type, insertion and removal dates, and other notes – can also be documented via the app.
- All data entered in the app is instantly transferred to the EHR system.
SOURCES:
- Forsström et al. (2025): Perifeeristen kanyyli-infektioiden torjuntaa tehostetaan digitaalisella seurannalla. Infektioidentorjunta 3/25.
- HUS Infectious Diseases Clinic, guideline 6.3.2023. Retrieved 3 Dec 2025.
- Päivinen & Kosonen (2021): VIP Score and the assessment of the condition of the skin at the cannula site – Instructional video for Kuopio University Hospital. Thesis, Savonia University of Applied Sciences. Retrieved 3 Dec 2025.
- Ostrobothnia Wellbeing Services County (31.3.2023): Kanyylin pistokohdan ihon arviointi (VIP-SCORE). Retrieved 3 Dec 2025.