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BEME Guide

What features of educational interventions lead to competence in aseptic insertion and maintenance of CV catheters in acute care? BEME Guide No. 15

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Pages 198-218 | Published online: 10 Mar 2010
 

Abstract

Background: Up to 6000 patients per year in England acquire a central venous catheter (CVC)-related bloodstream infection (Shapey et al. Citation). Implementation of Department of Health guidelines through educational interventions has resulted in significant and sustained reductions in CVC-related blood stream infections (Pronovost et al. 2002), and cost (Hu et al. Citation).

Aim: This review aimed to determine the features of structured educational interventions that impact on competence in aseptic insertion technique and maintenance of CV catheters by healthcare workers.

Methods: We looked at changes in infection control behaviour of healthcare workers, and considered changes in service delivery and the clinical welfare of patients involved, provided they were related directly to the delivery method of the educational intervention.

Results: A total of 9968 articles were reviewed, of which 47 articles met the inclusion criteria.

Conclusions: Findings suggest implications for practice: First, educational interventions appear to have the most prolonged and profound effect when used in conjunction with audit, feedback, and availability of new clinical supplies consistent with the content of the education provided. Second, educational interventions will have a greater impact if baseline compliance to best practice is low. Third, repeated sessions, fed into daily practice, using practical participation appear to have a small, additional effect on practice change when compared to education alone. Active involvement from healthcare staff, in conjunction with the provision of formal responsibilities and motivation for change, may change healthcare worker practice.

Additional information

Notes on contributors

M. Gemma Cherry

GEMMA CHERRY, BSc, is a researcher in the Centre for Excellence in Developing Professionalism in the School of Medical Education, University of Liverpool. Her special interests relate to emotional intelligence and attachment within medical education, and psychological underpinnings of violence within secure settings.

Jeremy M. Brown

JEREMY M. BROWN, BA (Joint Hons), PGCE, PhD, is a senior lecturer in the Evidence-based Practice Research Centre, Faculty of Health, Edge Hill University. His special interests relate to teaching and learning in Postgraduate Medical Education and transitions in medical careers. His post is half funded by Mersey Deanery.

Timothy Neal

TIMOTHY NEAL, MB, MSc, FRCPath, is a consultant microbiologist at the Royal Liverpool University Hospital and the Liverpool Women's (NHS) Foundation Trust where he is also the Director of Infection Prevention and Control. His special interests relate to the prevention and treatment of infections in preterm neonates.

Nigel Ben Shaw

NIGEL SHAW, MB ChB, MRCP (UK), FRCPCH, MD, MA (Clin Ed), is a consultant in Neonatal and Respiratory Paediatrics at Liverpool Women's Hospital and The Royal Liverpool Children's Hospital, Associate Postgraduate Dean at Mersey Deanery and visiting professor to the Evidence-based Research Centre, Faculty of Health, Edge Hill University. His special interests relate to postgraduate teaching and learning in medicine, use of postgraduate portfolios and assessment tools and educational interventions which maintain clinical skills.

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