Document Detail


Managing peripheral venous catheters: an investigation on the efficacy of a strategy for the implementation of evidence-based guidelines.
MedLine Citation:
PMID:  21114722     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
RATIONALE, AIMS AND OBJECTIVES: Until now, the evaluation of the effectiveness of guideline implementation in nursing and allied health professions has received relatively little attention. The aims of this study were (i) to describe the development process of guidelines concerning the management of peripheral venous catheters (PVCs) implemented in an Italian hospital; and (ii) to evaluate the effectiveness of guideline dissemination in terms of both clinical outcomes (signs of infection) and process outcomes (measures of appropriateness of PVC management).
METHODS: An observational study was conducted before and after the adoption of a new protocol in the CTO-CRF-Maria Adelaide Hospital. Data from 306 PVCs (153 before and 153 after) were collected. For each PVC, a wide range of outcome measures was collected, including: data on fixation system type of dressing; visibility of the insertion site; registration of the insertion date; duration of catheter insertion; presence of connectors, taps and needles; and signs of infection. The effect of guideline implementation was evaluated using a logistic regression model to adjust for the confounding variable represented by the nurses' average years of working experience.
RESULTS: The risk of using inappropriate dressing was significantly reduced [odds ratio (OR) 0.43; 95% confidence interval (CI) 0.27-0.70], while the use of transparent dressing increased (OR 2.39; 95% CI 1.46-3.89).
CONCLUSION: Our study shows significant improvement in practices relevant to the correct management of PVCs 2 months after guideline implementation. A second survey (after a minimum of 6 months) is necessary to assess persistence of improvement in clinical practices.
Authors:
Simona Frigerio; Paola Di Giulio; Dario Gregori; Dario Gavetti; Simonetta Ballali; Silvia Bagnato; Gabriella Guidi; Francesca Foltran; Giovanni Renga
Publication Detail:
Type:  Journal Article     Date:  2010-11-30
Journal Detail:
Title:  Journal of evaluation in clinical practice     Volume:  18     ISSN:  1365-2753     ISO Abbreviation:  J Eval Clin Pract     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-03-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9609066     Medline TA:  J Eval Clin Pract     Country:  England    
Other Details:
Languages:  eng     Pagination:  414-9     Citation Subset:  IM    
Copyright Information:
© 2010 Blackwell Publishing Ltd.
Affiliation:
Quality Office, CTO-CRF-M. Adelaide Hospital, Torino, Italy.
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