Foucault-Fruchard L, van der Mee N, Reinprecht C, Durand C, Cailhol J, Zahar J R, Kerneis S
IAME, Université Paris Cité, 16 Rue Henri Huchard, Paris, 75018, France.
Pharmacie À Usage Intérieur (PUI), Hôpital Bretonneau - CHU de Tours, 2 Boulevard Tonnellé, Tours, 37000, France.
Antimicrob Resist Infect Control. 2025 Jun 11;14(1):67. doi: 10.1186/s13756-025-01583-w.
Central venous catheters offer considerable benefits, but their presence can expose patients to serious complications. Preventing such complications is crucial, not only for individual patients, but also for hospitals and the healthcare system.
To assess the impact of educational interventions on clinical and non-clinical outcomes provided to patients with central venous catheters and/or their informal caregivers, regardless of the therapeutic indication, and to define the specific characteristics of effective educational strategies.
Medline and Embase were searched, covering all publications since their inception to 13 August 2024. Articles on clinical and/or non-clinical outcomes related to the education of patients with central venous catheters and their informal caregivers were included. Studies focusing solely on the education of healthcare providers were excluded. The reference lists of included studies were hand searched for additional citations. This systematic review followed PRISMA guidelines and the protocol was registered in PROSPERO (CRD42024577193). The quality of the included studies was assessed using the Mixed Methods Appraisal Tool.
In total, 20 articles, representing 974 patients and 875 informal caregivers, were included in the review: seven randomized trials, ten quantitative studies without randomization, and three descriptive quantitative studies. The compliance rate of 60% for the randomised trials determined using the Mixed Methods Appraisal Tool indicates a low risk of bias, whereas non-randomised and descriptive quantitative studies show more methodological weaknesses (40% and 45%, respectively). There was a positive trend, significant or not, for the impact of patient education on reducing complications, particularly those related to infection (85% of the studies concerned by this outcome). This was often observed (64%) in studies based on educational interventions repeated over time. Studies that showed a significant improvement in patients' knowledge and skills in terms of self-management showed beneficial results in terms of the occurrence of complications. Nurses were the most common educators (15/20), and the most frequently used tools were written materials and digital resources, often combined with other methods for greater effectiveness.
This systematic review encourages the implementation of educational interventions for patients with central venous catheters and their informal caregivers, notably to decrease infections. Providing them with written documents and digital tools, and delivering them repeatedly over time, should be promoted. However, study heterogeneity limits definitive conclusions. Future research should standardize methodologies, involve patients in intervention design, and assess cost-effectiveness to ensure sustainable implementation.
中心静脉导管有诸多益处，但其存在会使患者面临严重并发症。预防此类并发症至关重要，不仅对个体患者，对医院及医疗系统亦是如此。
评估教育干预对中心静脉导管患者及其非正式照护者的临床和非临床结局的影响，无论治疗指征如何，并确定有效教育策略的具体特征。
检索了Medline和Embase，涵盖自创立至2024年8月13日的所有出版物。纳入了与中心静脉导管患者及其非正式照护者教育相关的临床和/或非临床结局的文章。仅关注医疗服务提供者教育的研究被排除。对纳入研究的参考文献列表进行手工检索以获取更多引用。本系统评价遵循PRISMA指南，方案已在PROSPERO（CRD42024577193）注册。使用混合方法评估工具评估纳入研究的质量。
本评价共纳入20篇文章，涉及974例患者和875名非正式照护者：7项随机试验、10项非随机定量研究和3项描述性定量研究。使用混合方法评估工具确定的随机试验60%的依从率表明偏倚风险较低，而非随机和描述性定量研究显示出更多方法学弱点（分别为40%和45%）。患者教育对减少并发症，特别是与感染相关的并发症的影响存在显著或不显著的积极趋势（85%的研究涉及此结局）。这在基于随时间重复进行的教育干预的研究中经常观察到（64%）。在患者自我管理知识和技能方面显示出显著改善的研究在并发症发生方面显示出有益结果。护士是最常见的教育者（15/20），最常用的工具是书面材料和数字资源，通常与其他方法结合使用以提高有效性。
本系统评价鼓励对中心静脉导管患者及其非正式照护者实施教育干预，特别是为了减少感染。应推广为他们提供书面文件和数字工具，并随时间重复提供。然而，研究的异质性限制了确定性结论。未来的研究应规范方法，让患者参与干预设计，并评估成本效益以确保可持续实施。
