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
Tomás Vecina S, Mozota Duarte J, Ortega Marcos M, Ruiz Navarro MG, Borillo V, San Juan Gago L, Roqueta Egea F, Chanovas Borràs M
Objectives.
To test a strategy to reduce the rate of adverse events in patients and safety problems for emergency department staff who insert peripheral venous catheters (PVCs). The strategy consisted of training, implementing a protocol, and introducing safety-engineered PVCs.
Methods.
Prospective, multicenter, observational, preauthorization study in patients requiring PVC placement in an emergency department. The study had 2 phases. The first consisted of training, implementing a protocol for using conventional PVCs, and monitoring practice. The second phase introduced safety-engineered PVC sets. The number of adverse events in patients and threats to safety for staff were compared between the 2 phases.
Results.
A total of 520 patients were included, 180 in the first phase and 340 in the second. We detected breaches in aseptic technique, failure to maintain a sterile field, and improper management of safety equipment and devices. Some practices improved significantly during the second phase. Eighty-six adverse events occurred in the first phase and 52 (15.4%) in the second; the between-phase difference was not statistically significant. The incidence of postinfusion phlebitis was 50% lower in the second phase. Seven splash injuries and 1 accidental puncture occurred with conventional
PVCs in the first phase; 2 splash injuries occurred with the safety-engineered PVCs in the second phase (36% decrease, P = .04). Differences were particularly noticeable for short-term PVC placements (P = .02).
Conclusion. Combining training, a protocol, and the use of safety-engineered PVC sets offers an effective strategy for improving patient and staff safety.
