Sustained improvements in peripheral venous catheter care in non-intensive care units: a quasi-experimental controlled study of education and feedback.

Abstract

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: Mohamad G Fakih, Karen Jones, Janice E Rey, Dorine Berriel-Cass, Tatyana Kalinicheva, Susanna Szpunar, Louis D Saravolatz
• Journal: Infection control and hospital epidemiology (Infect Control Hosp Epidemiol) Vol. 33 Issue 5 Pg. 449-55 (May 2012) ISSN: 1559-6834 [Electronic] United States
• PMID: 22476270 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Topics

• Catheter-Related Infections (prevention & control)
• Catheterization, Peripheral (standards)
• Feedback
• Hospitals, Teaching
• Humans
• Prospective Studies
• Quality Assurance, Health Care (methods)