BACKGROUND AND OBJECTIVES:Peripheral venous catheters (PVCs) can be associated with serious infectious complications. We evaluated the effect of education and feedback on process measures to improve PVC care and infectious complications. DESIGN: Quasi-experimental controlled crossover study with sampling before and after education. SETTING: An 804-bed tertiary care teaching hospital. PARTICIPANTS: Nurses and patients in 10 non-intensive care units. METHODS: We implemented a process to improve PVC care in 10 non-intensive care units. The 4 periods (each 3 months in duration) included a preintervention period and a staggered educational intervention among nurses. During intervention period 1, 5 units participated in the intervention (group A), and 5 units served as a control group (group B). Group B underwent the intervention during intervention period 2, and both groups A and B received feedback on performance during intervention period 3. Process measures were evaluated twice monthly, and feedback was given to nurses directly and to the unit manager on a monthly basis. RESULTS: During the preintervention period, there were no significant differences between groups A and B. Of 4,904 intravascular catheters evaluated, 4,434 (90.4%) were peripheral. By the end of the study, there were significant improvements in processes, compared with the preintervention period, including accurate documentation of dressing (from 442 cases [38%] to 718 cases [59%]; P < .0001), catheter dressing being intact (from 968 cases [88.5%] to 1,024 cases [95.2%]; P < .0001), and correct demonstration of scrubbing the hub before infusion (from 161 demonstrations [54%] to 316 demonstrations [95%]; P < .0001). There was a significant reduction in PVC-associated bloodstream infection, from 2.2 cases per 10,000 patient-days during the preintervention period (5 cases) to 0.44 cases per 10,000 patient days during the 3 intervention periods (3 cases; P = .016). CONCLUSIONS: Education and real-time feedback to nurses increases and sustains compliance with processes to reduce the risk of infection from PVCs.
RCT Entities:
BACKGROUND AND OBJECTIVES: Peripheral venous catheters (PVCs) can be associated with serious infectious complications. We evaluated the effect of education and feedback on process measures to improve PVC care and infectious complications. DESIGN: Quasi-experimental controlled crossover study with sampling before and after education. SETTING: An 804-bed tertiary care teaching hospital. PARTICIPANTS: Nurses and patients in 10 non-intensive care units. METHODS: We implemented a process to improve PVC care in 10 non-intensive care units. The 4 periods (each 3 months in duration) included a preintervention period and a staggered educational intervention among nurses. During intervention period 1, 5 units participated in the intervention (group A), and 5 units served as a control group (group B). Group B underwent the intervention during intervention period 2, and both groups A and B received feedback on performance during intervention period 3. Process measures were evaluated twice monthly, and feedback was given to nurses directly and to the unit manager on a monthly basis. RESULTS: During the preintervention period, there were no significant differences between groups A and B. Of 4,904 intravascular catheters evaluated, 4,434 (90.4%) were peripheral. By the end of the study, there were significant improvements in processes, compared with the preintervention period, including accurate documentation of dressing (from 442 cases [38%] to 718 cases [59%]; P < .0001), catheter dressing being intact (from 968 cases [88.5%] to 1,024 cases [95.2%]; P < .0001), and correct demonstration of scrubbing the hub before infusion (from 161 demonstrations [54%] to 316 demonstrations [95%]; P < .0001). There was a significant reduction in PVC-associated bloodstream infection, from 2.2 cases per 10,000 patient-days during the preintervention period (5 cases) to 0.44 cases per 10,000 patient days during the 3 intervention periods (3 cases; P = .016). CONCLUSIONS: Education and real-time feedback to nurses increases and sustains compliance with processes to reduce the risk of infection from PVCs.
Authors: Caroline O'Neil; Kelly Ball; Helen Wood; Kathleen McMullen; Pamala Kremer; S Reza Jafarzadeh; Victoria Fraser; David Warren Journal: Infect Control Hosp Epidemiol Date: 2016-03-21 Impact factor: 3.254
Authors: Bart J Laan; Ingrid J B Spijkerman; Mieke H Godfried; Berend C Pasmooij; Jolanda M Maaskant; Marjon J Borgert; Brent C Opmeer; Margreet C Vos; Suzanne E Geerlings Journal: BMC Infect Dis Date: 2017-01-10 Impact factor: 3.090
Authors: Poonam Gupta; Mincy Thomas; Ashfaq Patel; Reeba George; Leena Mathews; Seenu Alex; Siji John; Cherlyn Simbulan; Ma Leni Garcia; Sara Al-Balushi; Mawahib El Hassan Journal: BMJ Open Qual Date: 2021-02
Authors: Niccolò Buetti; Jonas Marschall; Marci Drees; Mohamad G Fakih; Lynn Hadaway; Lisa L Maragakis; Elizabeth Monsees; Shannon Novosad; Naomi P O'Grady; Mark E Rupp; Joshua Wolf; Deborah Yokoe; Leonard A Mermel Journal: Infect Control Hosp Epidemiol Date: 2022-04-19 Impact factor: 6.520