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Eur J Clin Microbiol Infect Dis. 2018 Jun;37(6):1163-1168. doi: 10.1007/s10096-018-3236-4. Epub 2018 Mar 22.

Impact of a training program on adherence to recommendations for care of venous lines in internal medicine departments in Spain.

Author information

1
Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain. mariaguembe@hotmail.com.
2
Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, Spain. mariaguembe@hotmail.com.
3
Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario Gregorio Marañón, C/ Dr. Esquerdo, 46, 28007, Madrid, Spain. mariaguembe@hotmail.com.
4
Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, Spain.
5
CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain.
6
Cardiac Surgery Postoperative Care Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
7
Grupo de Trabajo en Enfermedades Infecciosas de la Sociedad Española de Medicina Interna (GTEI-SEMI), Madrid, Spain.
8
Department of Internal Medicine, Hospital de Mataró, Barcelona, Spain.
9
Department of Internal Medicine, Hospital de Montepríncipe, Madrid, Spain.
10
Department of Internal Medicine, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
11
Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
12
Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain.

Abstract

A high percentage of venous lines (VLs) are placed in non-ICU patients, particularly those treated in the internal medicine department (IMD). We assessed adherence to VL care after a training program aimed at nurses and clinicians attending patients admitted to Spanish IMDs. We performed a multicenter prospective observational point prevalence study in 14 Spanish IMDs in 2013 and 2016. We included all adult patients (> 18 years) admitted to IMDs on the study day and reviewed nursing records for patients with VL in place before and after a 1-year training program during 2015. Answers from an interview with head nurses of the IMDs regarding commonly used practices in the daily management of VLs were also compared. A total of 638 and 693 patients were seen during each period, respectively, and 530 and 598 patients had ≥ 1 VL implanted (83.1 vs. 86.3%). Catheters were considered unnecessary in 12.8 and 15.0% of cases (p = 0.28). Daily recording of the need for catheter use increased from 43.8 to 71.8% (p < 0.001). Furthermore, daily monitoring of the insertion site remained very frequent (94.4 vs. 92.2%; p = 0.16). The date of insertion was recorded in 86.3 and 85.5% of cases (p = 0.73), and no combination of closed connectors with open caps increased from 74.8 to 90.3% (p < 0.001). Overall, head nurses' knowledge improved in 4 out of 14 recommendations assessed (28.6%). A simple and easy program for training on management of VLs in Spanish IMDs was associated with improved quality of care.

KEYWORDS:

Central venous line; Impact; Internal medicine department; Training program

PMID:
29569044
DOI:
10.1007/s10096-018-3236-4
[Indexed for MEDLINE]

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