Research for infection protection
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Author: Kampf G et al. (2013) Source: GMS Hygiene and Infection Control 2013; 8(2):DOC18


Kampf G et al. (2013)

Improving patient safety during insertion of peripheral venous catheters: an observational intervention study

Background: Peripheral venous catheters are frequently used in hospitalized patients but increase the risk of nosocomial bloodstream infection. Evidence-based guidelines describe specific steps that are known to reduce infection risk. The aim of this study was to determine the use of specific steps for insertion of peripheral venous catheters in clinical practice and to implement a multimodal intervention aimed at improving both compliance and the optimum order of the steps.

Methods: The study was conducted at University Hospital Hamburg. An optimum procedure for inserting a peripheral venous catheter was defined based on evidence-based guidelines of the WHO, CDC and RKI. Five steps with relevance for patient safety (evidence level 1A or 1B) were identified for observation of compliance analysis and intervention: hand disinfection before patient contact, skin antisepsis of the puncture site, no palpation of treated puncture site, hand disinfection before aseptic procedure, and sterile dressing on the puncture site. A research nurse observed and recorded procedures for peripheral venous catheter insertion for healthcare workers in four different hospital departments. A multimodal intervention with 5 elements was established (teaching session, dummy training, e-learning tool, tablet and poster, and direct feedback), followed by a second observation period. During the last observation week, participants evaluated the intervention.

Results: After intervention compliance with four of five specific steps was higher than before intervention (e.g., 11.6 % before and 57.9 % after intervention for hand disinfection before patient contact). Compliance with skin antisepsis of the puncture site was high before and after intervention (99.5 % before and 99.0 % after). Performance of specific steps in the correct order also improved significantly (e.g., from 7.7 % to 68.6 % when three of five steps were done). The intervention was described as helpful by 46.8 % of the participants, as neutral by 46.8 %, and as disruptive by 6.4 %.

Conclusions: A multimodal strategy to improve both compliance with safety steps for peripheral venous catheter insertion and performance of an optimum procedure was effective and was regarded helpful by healthcare workers.

GMS Hygiene and Infection Control 2013; 8(2):DOC18

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