Impact of a training program on adherence to recommendations for care of venous lines in internal medicine departments in Spain
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.
KeywordsCentral venous line Training program Impact Internal medicine department
We thank Thomas O’Boyle for his help in the preparation of the manuscript.
We thank the members of the NUVE study group for their contribution to the study:
Hospital General Universitario Gregorio Marañón (Madrid): Jesús Millán, Carlos Pérez de Oteyza, Antonio Muiño, Mariví Villalba, Carmen Cuenca, Jesús García Castaño, Cecilia Muñoz Delgado, Sonia Zamorano, Beatriz Gómez, and José Manuel Collado.
Hospital L’Esperit Sant (Cataluña): Miguel Torres Salinas, Alex Smithson Amat, and Javier Ramos Lázaro.
Hospital de Santa Bárbara (Castilla La Mancha): Valentín del Villar Sordo and Mario del Valle Sánchez.
Hospital de Mataró (Cataluña): Ángela Felip Benach, Elena Vidal, and Laia Albiach.
Hospital de Txagorritxu (País Vasco): José Manuel Agud Aparicio and Esther Saéz de Adana Arroniz.
Hospital Santa Creu i Sant Pau (Cataluña): Jordi Casademont i Pou and Virginia Pomar Solchaga.
Hospital Reina Sofía (Navarra): Fernando Escolar Castellón and Teresa Rubio Obanos.
Hospital Universitario de Cruces (País Vasco): Maria Victoria Egurbide Arberas, Javier Nieto Arana and Eduardo García López.
Hospital Universitario Sant Joan de Reus (Cataluña): Antonio Castro Salomó and Simona Micaela Iftimie.
Hospital General La Mancha Centro (Castilla La Mancha): Antonio Martín Castillo and José Ramón Barberá Farré.
Hospital de Tortosa Verge de la Cinta (Cataluña): Amat Ortí Lavería, Mercé Cardona Ribera and Naya Bellaubí Pallarés.
Hospital Santos Reyes (Burgos): Pedro Cancelo Suárez, Francisco Javier Cepeda Piorno, Noelia Arenal Andrés and Raquel Elisa Rodríguez Tarazona.
Hospital Universitario de Guadalajara (Castilla La Mancha): Manuel Miguel Rodríguez Zapata and María Asunción Costa Cerdá.
Hospital Comarcal de Valdeorras (Galicia): José Felipe Morales Martín and Josep Masferrer Serra.
Hospital Universitario de Bellvitge (Cataluña): Xavier Corbella, Miquel Pujol, Eunice Pere and Ana Hornero.
M. Guembe is supported by the Miguel Servet Program (ISCIII-MICINN, CP13/00268) from the Health Research Fund (FIS) of the Carlos III Health Institute (ISCIII), Madrid, Spain. The study was partially funded by the European Regional Development Fund (FEDER) “A way of making Europe” (PI14/01933) and Fundación Española de Medicina Interna (FEMI).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This study was approved by the Ethics Committee of Hospital Gregorio Marañón.
The Ethics Committee of Hospital Gregorio Marañón required written informed consent to be obtained from the patients included in the study.
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