Authors

Silvia Rodríguez Aparicio1, Mª Luisa Guitard Sein-Echaluce2, Mercedes Palomar Martínez3

Position

1Máster en Enfermería. Enfermera Servicio Cardiología. Hospital Universitario Arnau de Vilanova de Lleida. Lleida2Doctora por la Universidad de Lleida. Facultad de Enfermería y Fisioterapia. Universidad de Lleida. Lleida3Doctora por la Universidad Autónoma de Barcelona. Facultad de Medicina. Universidad de Bellaterra. Lleida

Contact address

Silvia Rodríguez Aparicio. Avda. Germanies, 28. 25198 Lleida

Contact email: silvia.rodriguez@infermeria.udl.cat

Abstract

Objective: to understand the difficulties for implementing the recommendations according to the Care Bundle in order to prevent the complications associated with vascular access devices, and to assess those factors associated with the difficulties identified.
Method: a descriptive transversal study, with a population formed by clinicians and nurses from the Hospital Universitario Arnau de Vilanova (HUAV) in Lleida. A pre-and-post training intervention questionnaire was applied, with a 4-month-interval. Training consisted in a 1-hour training session targeted to all professionals in the study, on the importance of implementing the eight most relevant recommendations in the Care Bundle. Descriptive and bivariate analysis was conducted.
Results: the study included 150 (31%) professionals in the pre-intervention and 184 (38%) in the post-intervention stages. The most prevalent difficulties in both stages were: removing unnecessary catheters (38 (25.3%) vs. 32 (17.4%)), daily maintenance of catheters (47 (31.3%) vs. 48 (26.1%)), hygienic management and/or access to the circulatory system (44 (29.3) vs. 25 (13.6)) and replacing peripheral vein catheters according to protocol (68 (45.6) vs. 73 (39.7)). The factors associated with both difficulties were: mainly being a nurse (p< 0.05) and the surgical (p< 0.05) and hospitalization work units (p< 0.05).
Conclusions: the most prevalent difficulties for implementing the recommendations according to the Care Bundle were: removing unnecessary catheters, daily maintenance of central and/or peripheral IV lines, hygienic management and/or access to the circulatory system through central or peripheral venous catheter, and replacing peripheral vein catheters according to protocol. The factors associated with these difficulties were professional category and the unit where the patient is managed.

Keywords:

catheter-associated infections; patient care; bacteremia; patient care bundles; vascular access devices

Versión en Español

Título:

Dificultades en el cumplimiento de recomendaciones para prevenir las complicaciones asociadas a dispositivos de acceso vascular