Impact d’un programme prolongé d’amélioration continue de la qualité sur le risque infectieux lié aux cathéters veineux périphériques

Lolom, Isabelle; Deblangy, Claude; Capelle, A.; Guerinot, Wafaa; Bouvet, E.; Barry, B.; Goyau, Katel; L’Hériteau, F.; Bonnal, Christine; Lucet, Jean‐Christophe

doi:10.1016/j.lpm.2008.03.017

Cited by 21 publications

(3 citation statements)

References 7 publications

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“…With a presumed 250 million cases and an incidence of 21.6 per 1,000 admissions alone in the USA, the rates of nosocomial BSI are rather high [7,8]. Of all nosocomial BSI, 6.3-23 % are attributed to PIV and their incidence can be reduced by up to 70 % with trained staff and standard hygiene protocols [9][10][11][12][13]. Reducing the rate of nosocomial BSI would not only lessen BSI-associated mortality and morbidity risk, but also reduce health care costs of up to $40,000 per case [9,14,15].…”

Section: Introductionmentioning

confidence: 99%

Deterioration in hygiene behavior among fifth-year medical students during the placement of intravenous catheters: a prospective cohort comparison of practical skills

et al. 2021

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Background The American Association of Medical Colleges has defined peripheral intravenous cannulation as one of the eight practical skills that a medical student should possess upon graduation. Since following a standard hygiene protocol can reduce the rate of complications such as bloodstream infections, the medical student’s compliance to hygienic standards is highly relevant. Methods This unicentric longitudinal cohort study included 177 medical students undergoing OSCE 1 in the winter semesters 2016/2017 and 2017/2018 as well as OSCE 2 during the winter semesters 2018/2019 and 2019/2020 at the University of Cologne. Their performance in peripheral intravenous cannulation was rated by trained student supervisors using a scaled 13-item questionnaire and compared between OSCE 1 and OSCE 2. Results Overall, a decline in the correct placement of peripheral intravenous catheters was observed among advanced medical students during OSCE 2 (mean total score: 6.27 ± 1.84) in comparison to their results in OSCE 1 (mean total score: 7.67 ± 1.7). During OSCE 2, the students were more negligent in regard to hygienic behavior, such as disinfection of the puncture site as well as hand disinfection before and after venipuncture. Their patients were also less likely to be informed about the procedure as compared to OSCE 1. Conclusions An unsatisfying performance in regard to peripheral intravenous cannulation was observed in medical students with hygiene compliance deteriorating between the third and fifth year of their study. Thus, we promote an extension of practical hygiene and stress management training in medical school to reduce complications associated with intravenous catheters, such as bloodstream infections.

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Section: Introductionmentioning

confidence: 99%

Deterioration in hygiene behavior among fifth-year medical students during the placement of intravenous catheters: a prospective cohort comparison of practical skills

et al. 2021

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“…The most frequently reported PIVC-related complications are phlebitis, infiltration, obstruction, extravasation, and accidental removal [3,4,8,12,13]. However, catheter-related bloodstream infections are also highlighted in contemporary literature as a potential negative PIVC outcome [14,15,16].…”

Section: Introductionmentioning

confidence: 99%

Impact of an Innovative Securement Dressing and Tourniquet in Peripheral Intravenous Catheter-Related Complications and Contamination: An Interventional Study

Parreira

Serambeque

Santos-Costa

et al. 2019

IJERPH

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Reusable tourniquets and conventional securement dressings are considered risk factors for the occurrence of reported complications and catheter-related bloodstream infections. This study’s purpose is to assess the impact of single-use disposable tourniquets and advanced occlusive polyurethane dressings with reinforced cloth borders on peripheral intravenous catheter (PIVC)-related complications and contamination. A pre- and post-interventional prospective observational study was conducted in a cardiology ward of a tertiary hospital between April 2018 and February 2019. Overall, demographic and clinical data from 156 patients and PIVC-related outcomes were collected (n = 296) as well as PIVC tips for microbiological analysis (n = 90). In the pre-intervention phase (n = 118), complication rates of 62.1% were reported, while 44.1% of the PIVCs were contaminated (n = 34). In the post-intervention phase (n = 178), complication rates decreased to 57.3%, while contamination rates significantly decreased to 17.9% (p = 0.014; n = 56). Through a logistic regression, it was found that the use of innovative technologies reduces the chance of PIVC contamination by 79% (odds ratio (OR): 0.21; 95% confidence interval (CI): 0.05–0.98; p = 0.046). Meanwhile, PIVC-related complications and fluid therapy emerged as predictors for PIVC contamination. Findings suggest that the adoption of these innovative devices in nurses’ practice contributes to the significant reduction of PIVC contamination.

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“…Catheter contamination can occur when it is being attached or later when it is being used. The incidence of PVC-induced sepsis is 0.2 to 0.7 per 1000 catheter days and a total of 0.08 for each catheter (6,7).…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Effects of Alcohol, Chlorhexidine and Alcohol-Chlorhexidine on Local Catheter-Related Infections Rate: A Double-Blind Clinical Trial Study

Sarani¹,

Moulaei²,

Tabas³

et al. 2018

Med Surg Nurs J

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Background: Although it is vital to prevent catheter-related infections (CRIs) as the most common cause of hospital infections, there is still no agreement on the best antiseptic agent. Objectives: The aim of the present study was to compare the effects of chlorhexidine, alcohol, and alcohol-chlorhexidine solutions on local CRIs in patients admitted to coronary care units (CCUs). Methods: This randomized double-blind clinical trial was performed on 150 patients admitted to the CCUs of the hospitals affiliated to Zahedan University of Medical Sciences, Iran, in 2017. The subjects were selected using the convenience sampling method and randomly divided into three groups of 50, including groups A (alcohol), B (chlorhexidine), and C (alcohol-chlorhexidine). The injection site was disinfected with 70% alcohol, chlorhexidine solution, chlorhexidine-alcohol solutions in groups A, B, and C at a radius of 5 cm from the center. Local CRIs rate was assessed based on results of a culture test. After removing the catheter from the vessel, the tip was separated with a scissor and transferred to the culture medium under sterile conditions. It was then sent to laboratory for microbiological evaluation, and the culture results were compared. In case of growth of more than 15 colonies in each plate, the colony was considered to be positive. Patients and laboratory experts who reviewed and reported the results of the culture were blind to the group allocations. Data were then analyzed by using Chi-square test and Fisher's Exact test in SPSS, version 16. Results: We found a significant difference between the three groups in terms of local CRIs (A: 20%, B: 22%, and C: 4%; P: 0.024). There was a significant difference between the chlorhexidine and alcohol-chlorhexidine groups (P = 0.007) and between the alcohol and alcohol-chlorhexidine groups in this regard (P = 0.014). The prevalence of local CRIs was significantly lower in the alcoholchlorhexidine group than the alcohol and chlorhexidine groups. Conclusions: Since the findings of the present research showed that skin cleansing with alcohol-chlorhexidine solution compared to alcohol and chlorhexidine could more effectively reduce local CRIs, it is recommended to use this formulation for disinfection of the intravenous catheterization site.

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Impact d’un programme prolongé d’amélioration continue de la qualité sur le risque infectieux lié aux cathéters veineux périphériques

Cited by 21 publications

References 7 publications

Deterioration in hygiene behavior among fifth-year medical students during the placement of intravenous catheters: a prospective cohort comparison of practical skills

Deterioration in hygiene behavior among fifth-year medical students during the placement of intravenous catheters: a prospective cohort comparison of practical skills

Impact of an Innovative Securement Dressing and Tourniquet in Peripheral Intravenous Catheter-Related Complications and Contamination: An Interventional Study

Comparison of the Effects of Alcohol, Chlorhexidine and Alcohol-Chlorhexidine on Local Catheter-Related Infections Rate: A Double-Blind Clinical Trial Study

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