title: Voiceover Interactive PowerPoint Catheter Care Education for Home Parenteral Nutrition.
abstract: BACKGROUND
  In home infusions via tunneled catheter/peripherally inserted central catheter (TC/PICC) the risk of catheter-related bloodstream infection (CRBSI) and complications contribute to rehospitalization and costs. It is unknown if voiceover interactive PowerPoint (VOIPP) via digital video disc education improves clinical outcomes.
  
  
  METHODS
  In a quaternary care medical center and using a randomized, controlled, 2-group design, hospitalized patients with TC/PICC received usual care education or usual care (UC) plus VOIPP education prehospital discharge. A multiple-choice 6-item knowledge questionnaire was administered preeducation, immediately posteducation, and 7-10 days postdischarge. At 90 days, patients were assessed for CRBSI incidence rates per 1000 catheter-days, rehospitalization, CRBSI-related hospitalization, non-CRBSI complications and patient calls to the home parenteral nutrition (HPN) clinicians. Analysis of variance, Pearson χ(2), and Kruskal-Wallis test were used to compare results between groups.
  
  
  RESULTS
  Of 51 patients (UC, n = 27; UC+VOIPP, n = 24), mean ± SD age was 46.3 ± 14.3 years, 68.6% were female, HPN duration was 2.2 ± 1.01 months, and time to postdischarge test completion was 11.5 ± 5.2 days. There were no baseline differences between groups. Between-group knowledge and changes in knowledge were similar at preeducation, immediate posteducation, and postdischarge (P = .88, 0.30, and 0.37, respectively). There were no differences in CRBSI incidence, rehospitalization, CRBSI-related rehospitalization rates, and non-CRBSI complications between groups. The UC+VOIPP group had more patient calls than did the UC group (21.8 vs 7.7 calls/1000 catheter-days, P < .001).
  
  
  CONCLUSIONS
  Recorded education led to more patient calls to the HPN clinicians; however, there were no differences between groups in other outcomes.
authors.affiliation: Center for Human Nutrition, Digestive Disease Institute emeryd2@ccf.org.
authors.forename: Dorothy
authors.initials: D
authors.lastname: Emery
authors.affiliation: Center for Human Nutrition, Digestive Disease Institute.
authors.forename: Annette
authors.initials: A
authors.lastname: Pearson
authors.affiliation: Quantitative Health Sciences.
authors.forename: Rocio
authors.initials: R
authors.lastname: Lopez
authors.affiliation: Center for Human Nutrition, Digestive Disease Institute.
authors.forename: Cindy
authors.initials: C
authors.lastname: Hamilton
authors.affiliation: Nursing Institute, Office of Research and Innovation, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Nancy M
authors.initials: NM
authors.lastname: Albert
mesh_terms: D000328:Adult; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000517:prevention & control; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D062905:Central Venous Catheters; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016331:Parenteral Nutrition, Home / Q000009:adverse effects* / Q000379:methods; D010351:Patient Discharge; D010353:Patient Education as Topic / Q000379:methods*; D010359:Patient Readmission; D012307:Risk Factors; D059039:Standard of Care; D011795:Surveys and Questionnaires
keywords: central venous catheters; home infusion therapy; home parenteral nutrition; infection; nutritional support; patient education