985 / Implementation of guidelines to prevent depletion of venous access

SPAIN
Classification of the PSP
Type of Patient Safety Practice Not Evaluated
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Handling of catheters
Infection control / Prevention of surgical site infections There is no specified text here
Topic of the reported practice
Patient safety system
Aim and the benefit of the Patient Safety Practice
 
The aim and benefit of this PSP is the prevention of adverse events in relation with venous access: phlebitis, infection, thrombophlebitis, thrombosis, infiltration, extravasation and particularly, catheter-related bacteremia. The aim consists also in the prevention of venous access depletion
Description of the Patient Safety Practice
 
It became necessary to implement a Care Good Practice about Vascular Access in our hospital.
To get it our intervention are based on the recommendations of two nursing best practice guidelines of RNAO: Care and Maintenance to ReduceVascular Access Complications. (April 2005, revised 2008) and Assessment and Device Selection for Vascular Access (May 2004, revised 2008).
An intravenous therapy team was created. Two specialist nurses were the members of this team working in collaboration with pharmacists, radiologists, microbiologists and physicians.
The functions of this team are: vascular access assessment, following the guidelines selection of correct access device, insertion of PICC and midlines using ultrasound-guided technique and patients, families andhospital stafftraining in vascular care.

Then, randomized clinical trial was conducted which was entitled “Nurse led Infusion Therapy
Team effectiveness on Length of Stay, venous Access complications and satisfaction of patients with long intravenous therapy”.The researches established two groups: patients in control group were attended by nurses giving usual care and patients in interventional group were attended by intravenous therapy team.This study shown us that the average length of stay in three-months was 19.4days (SD:12.9) for the control group and 15.4 (SD: 8.8) for the intervention group. The adjust of effect was -5.45 days (p = 0.012) in favor the group receiving intravenous therapy service. In relation with complications, the incidence was 3.3 times higher in the control group (p <0.001). Regarding satisfaction (scale 0-10), patients in the intervention group were 2.4 points more satisfied (p <0.001).
After finishing the study, the Intravenous Therapy Team was well consolidated in our hospital (HUA). Nowadays we are spreading the experience and carrying out training program in other hospitals of the Basque Health Service (Osakidetza) to promote similar intravenous therapy teams.

Attachment of relevant written information and/or photos, as appropriate
There is no specified text here
There is no specified text here
There is no specified text here
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, fully
Level of implementation of reported practice
Institution level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
Not relevant
A measurement after full implementation of the reported practice was obtained
Not relevant
Evaluation of a "positive" effect of the reported practice on Patient Safety
The evaluation showed improvements in Patient Safety outcomes
Type of before-and after evaluation
There is no specified text here
Enclosure of a reference or attachment in case of published evaluation's results
The results of the trial are awaiting publication.
There is no specified text here
Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
No
Specification of implementation in another health care setting(s)
There is no specified text here
Successful implementation's level  of this Patient Safety Practice across settings
There is no specified text here
Involved health care staff
 
Nurses
Scientific staff / researchers
Clinical manager
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
No
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
There is no specified text here
Point of time in which service user or their reprasentatives' involvement takes place
There is no specified text here
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
There is no specified text here
Short description of the service users' level of involvement
There is no specified text here
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
No
List of sources where public information is accessible
There is no specified text here
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
Yes
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
Lack of knowledge on implementation strategies
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
There is no specified text here
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
There is no specified text here
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
There is no specified text here
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
There is no specified text here
Contact information
 
Name: Inmaculada Moraza
Country: SPAIN
Organisation: HUA-TXAGORRITXU (OSAKIDETZA)
E-mail: inmalur@gmail.com
Phone: 609331226
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