Successful multifaceted intervention aimed to reduce short peripheral venous catheter-related adverse events: a quasiexperimental cohort study.
BACKGROUND
Data concerning the effectiveness of strategies implemented to reduce short peripheral vein catheter (PVC)-related adverse events are scarce.


METHODS
A quasiexperimental study (2004-2011) was conducted to evaluate an intervention to reduce peripheral vein phlebitis (PVP) and PVC-related bloodstream infections (BSIs). Bundle intervention consisted of health care worker education and training, withdrawal of unnecessary catheters, exchange catheter policy, withdrawal of catheters at early stages of PVP, use of scales as a measuring tool, and repeated period-prevalence surveillance of PVC adverse events on wards. A Poisson exponentially weighted moving average control chart was used to assess time series analysis.


RESULTS
One thousand six hundred thirty-one patients with 2,325 short catheters inserted were prospectively followed. PVP decreased by 48% (12.1% [95% confidence interval (CI): 10.7-13.2] during the intervention period versus 23.3% [95% CI: 16.4-30.1] in preintervention period; P < .05), and no reduction of PVP measured as 1,000 catheter-days was noted (48.6 [95% CI: 46.1-51.2] vs 37.9 [95% CI: 24.5-51.4], P > .05). A significant incidence reduction in PVC-related BSIs and health care-acquired Staphylococcus aureus BSIs was also achieved.


CONCLUSIONS
A comprehensive multifaceted hospital approach was successful in reducing PVC-related adverse effects. Poisson exponentially weighted moving average control chart fits well as time series using Poisson data when very few events are present.
Nosocomial Infection Control Unit, Delfos Medical Center, Barcelona, Spain. mestre.ucin@centromedicodelfos.es
Gabriel
G
Mestre
Cristina
C
Berbel
Purificación
P
Tortajada
Margarita
M
Alarcia
Roser
R
Coca
Mari Mar
MM
Fernández
Gema
G
Gallemi
Irene
I
García
Mari C
MC
Aguilar
Jesús
J
Rodríguez-Baño
José A
JA
Martinez
D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D015331:Cohort Studies; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006282:Health Personnel / Q000193:education; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods; D008297:Male; D008875:Middle Aged; D010689:Phlebitis / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D015995:Prevalence; D011446:Prospective Studies; D013030:Spain / Q000453:epidemiology; D013203:Staphylococcal Infections / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D013211:Staphylococcus aureus