Implementation of a knowledge mobilization model to prevent peripheral venous catheter-related adverse events: PREBACP study—a multicenter cluster-randomized trial protocol

Abstract

BackgroundPeripheral venous catheters are the most commonly used invasive devices in hospitals worldwide. Patients can experience multiple adverse events during the insertion, maintenance, and management of these devices. Health professionals aim to resolve the challenges of care variability in the use of peripheral venous catheter through adherence to clinical practice guidelines. The aim of this cluster-randomized controlled trial is to determine the efficacy of a multimodal intervention on incidence of adverse events associated with the use of peripheral venous catheters in adult hospital patients. Additional aims are to analyze the fidelity of nurses and the relationship between contextual factors on the use of best available and the outcomes of the intervention.MethodsFive public hospitals in the Spanish National Health System, with diverse profiles, including one university hospital and four second-level hospitals, will be included. In total, 20 hospitalization wards will be randomized for this study by ward to one of two groups. Those in the first group receive an intervention that lasts 12 months implementing evidence-based practice in healthcare related to peripheral catheters through a multimodal strategy, which will contain updated and poster protocols insertion, maintenance and removal of peripheral venous catheters, technologies applied to e-learning, feedback on the results, user and family information related to peripheral catheter, and facilitation of the best evidence by face-to-face training session. Primary outcome measures: Incidence of adverse events associated with the use of peripheral venous catheters is measured by assessing hospital records. Secondary outcome measures: Nurses’ adherence to clinical practice guidelines, clinical outcomes, and the cost of implementing the multimodal intervention.DiscussionClinical implementation is a complex, multifaceted phenomenon which requires a deep understanding of decision-making, knowledge mobilization, and sense making in routine clinical practice. Likewise, the inclusion of strategies that promote fidelity to recommendations through multicomponent and multimodal intervention must be encouraged. The use of a transfer model could counterbalance one of the greatest challenges for organizations, the evaluation of the impact of the implementation of evidence in the professional context through quality indicators associated with prevention and control of infections.Trial registrationCurrent Controlled Trials ISRCTN10438530. Registered 20 March 2018.

Care of peripheral intravenous catheters in three hospitals in Spain: Mapping clinical outcomes and implementation of clinical practice guidelines

“…This study was essential to assess the clinical outcome indicators from CPG recommendations regarding the hospital environment as a baseline within a multimodal intervention [48]. We should integrate the best evidence while deepening the motivations and beliefs of health professionals during decision-making for successful implementation, but we must also pay attention to the context, the great neglected in the field of implementation science [49].…”

The use of the PARIHS framework in implementation research and practice—a citation analysis of the literature

“…The table is sorted on type of article, type of use of the PARIHS framework, author and year of publication Authors Ref Year of publ. Full title Country(ies) Setting PARIHS used: Type of article To plan/deliver an intervention In the analysis a In the evaluation of findings In any other way Chinman, Daniels, et al [ 23 ] 2017 Provision of peer specialist services in VA patient aligned care teams: Protocol for testing a cluster randomized implementation trial USA Primary health care setting ✓ ✓ ✓ Protocol Gordon, Lee, et al [ 24 ] 2018 A complex culturally targeted intervention to reduce Hispanic disparities in living kidney donor transplantation: An effectiveness-implementation hybrid study protocol USA Community/Social care setting ✓ ✓ ✓ Protocol Roberge, Fournier, et al [ 25 ] 2013 Implementing a knowledge application program for anxiety and depression in community-based primary mental health care: A multiple case study research protocol Canada Primary health care setting ✓ ✓ ✓ Protocol Blanco-Mavillard, Bennasar-Veny, et al [ 26 ] 2018 Implementation of a knowledge mobilization model to prevent peripheral venous catheter-related adverse events: PREBACP study-a multicenter cluster-randomized trial protocol Spain Hospital setting ✓ ✓ Protocol Bucknall, Harvey, et al [ 27 ] 2017 Prioritizing Responses Of Nurses To deteriorating patient Observations (PRONTO) protocol: Testing the effectiveness of a facilitation intervention in a pragmatic, cluster-randomized trial with an embedded process evaluation and cost analysis Australia Hospital setting …”

“…In these articles, the analysis was performed in different ways, primarily through mapping and comparing PARIHS to other frameworks or models or even policies, but also for general discussions on implementation and evidence-based practice. Among the 185 articles that reported using the PARIHS framework in the analysis, there were also 22 protocols where authors reported that the intention was to use the framework in the analysis [23][24][25][26][27][28][29][30][31][32][33][34][35][47][48][49][50][51][52][53][54][55].…”

Risk Factors for Difficult Peripheral Intravenous Cannulation. The PIVV2 Multicentre Case-Control Study

“…The quality of healthcare can be significantly improved by designing interventions to improve the efficacy of the first puncture, selecting the most appropriate catheter and reducing the pain of peripheral cannulation, thus minimising its adverse effects [10,15,33]. Early referral to a vascular access specialist team (VAST) with advanced knowledge and skills in catheter insertion and care, or interventions putting into practice the recommendations of experts in the management of vascular catheters, can help to avoid the adverse events associated with cannulation, and their associated costs [13,34].…”