Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, Spain.
Eur J Clin Microbiol Infect Dis. 2018 Jun;37(6):1163-1168. doi: 10.1007/s10096-018-3236-4. Epub 2018 Mar 22.
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.
大量的静脉置管（VL）被用于非 ICU 患者，特别是那些在内科部门（IMD）接受治疗的患者。我们评估了针对在西班牙 IMD 住院的患者的护士和临床医生进行培训后的 VL 护理依从性。我们在 2013 年和 2016 年在 14 家西班牙 IMD 进行了一项多中心前瞻性观察性时点患病率研究。我们纳入了在研究日入住 IMD 的所有成年患者（>18 岁），并在 2015 年的 1 年培训计划前后回顾了 VL 置管患者的护理记录。我们还比较了 IMD 护士长对 VL 日常管理中常用实践的访谈答案。在每个时期分别观察到 638 名和 693 名患者，分别有 530 名和 598 名患者有≥1 个 VL 植入（83.1% vs. 86.3%）。12.8%和 15.0%的病例认为导管是不必要的（p=0.28）。每日记录导管使用需求从 43.8%增加到 71.8%（p<0.001）。此外，插入部位的每日监测仍然非常频繁（94.4% vs. 92.2%；p=0.16）。86.3%和 85.5%的病例记录了插入日期（p=0.73），并且没有将封闭连接器与开口帽结合使用的比例从 74.8%增加到 90.3%（p<0.001）。总体而言，在评估的 14 项建议中，护士长的知识在 4 项中有提高（28.6%）。在西班牙 IMD 中，针对 VL 管理的简单易用的培训计划与护理质量的提高有关。
