Training in a multimodal strategy on the care of peripheral venous catheters: impact on the preservation of the patient’s vascular tree in a nephrology unit

Abstract

Introduction: An adequate development of arteriovenous fistulas is related to the state of the vasculature and the previous use of peripheral venous catheter (PVC). Objective: To evaluate the impact of training in a multimodal strategy to reduce complications related to PVC in a nephrology hospitalization unit. Material and Method: Quasi-experimental pre-post intervention study in patients with PVC in a nephrology hospitalization unit. The intervention was training in a multimodal strategy for PVC management based on 5 evidence-based measures. To determine the impact, the electronic medical records of the PVCs inserted in the 3 months prior to the training activity (PRE) versus 3 months later (POST) were analyzed. A descriptive and inferential analysis of the variables to be studied was performed. Results: PVC studied: PRE n=96, POST n=120. Average number of PVC/patient: PRE 2.07 vs. POST 1.75 (p=0.02). Caliber: PRE 18G 1%, 20G 18%, 22G 80%, 24G 1%; POST 20G 20%, 22G 80% (p=NS). Average duration: PRE 192h, <7 days 26% vs POST 171h, <7 days 30% (p = NS). Withdrawal causes: High/ not accurate PRE 41% vs POST 38% (p=NS), Phlebitis PRE 27% vs POST 13% (p=NS). Conclusions: Training in a multimodal strategy has managed to reduce: number of PVC per patient, number of phlebitis, use of PVC of greater caliber and time that remain inserted. A multimodal strategy on the PVCs management can help preserve the vascular tree in nephrological patients.