Complications of Peripherally Inserted Central Venous Catheters: A Retrospective Cohort Study.

BACKGROUND AND AIM: The use of venous catheters is a widespread practice, especially in oncological and oncohematological units. The objective of this study was to evaluate the complications associated with peripherally inserted central catheters (PICCs) in a cohort of patients. MATERIALS AND METHODS: In this retrospective cohort study, we included all patient carrying PICCs (n = 603) inserted at our institute between October 2010 and December 2013. The main variables collected were medical diagnosis, catheter care, location, duration of catheterization, reasons for catheter removal, complications, and nursing care. Complications were classified as infection, thrombosis, phlebitis, migration, edema, and/or ecchymosis. RESULTS: All patients were treated according to the same "nursing care" protocol. The incidence rate of complications was two cases per 1000 days of catheter duration. The most relevant complications were infection and thrombosis, both with an incidence of 0.17 cases per 1000 days of the total catheterization period. The total average duration of catheterization was 170 days [SD 6.06]. Additionally to "end of treatment" (48.42%) and "exitus", (22.53%) the most frequent cause of removal was migration (displacement towards the exterior) of the catheter (5.80%). CONCLUSIONS: PICCs are safe devices that allow the administration of long-term treatment and preserve the integrity of the venous system of the patient. Proper care of the catheter is very important to improve the quality life of patients with oncologic and hematologic conditions. Therefore, correct training of professionals and patients as well as following the latest scientific recommendations are particularly relevant.

Factores asociados a la técnica correcta en la higiene de manos / Factors related with the performance of a proper hand hygiene

Objetivo: Identificar factores asociados a la higienización de manos con técnica correcta en el contexto de una campaña de mejora. Material y método: Se realizaron 2 estudios transversales en 15 unidades asistenciales. La variable dependiente fue la técnica de higienización y las de exposición fueron aspectos asistenciales (grupo profesional, etc.) y relacionados con la campaña (formación en higiene de manos). Análisis estadístico: como medida de asociación se utilizó la odds ratio (OR) y su intervalo de confianza al 95% (IC 95%). El análisis ajustado se realizó mediante regresión logística.Resultados: El 12% de las higienizaciones se realizaron con técnica correcta. Entre los factores asociados destacan las unidades de cuidados intensivos (OR 4,07, IC 95% 1,95–8,51) y servicios quirúrgicos (OR 3,24, IC 95% 1,52–6,92), actividades de alto riesgo de transmisión de infección (OR 2,56, IC 95% 1,34–4,70) y el grupo de médicos (OR 2,52, IC 95% 0,93–6,85). La formación aumentó un 21% la probabilidad de higienización correcta por cada incremento de un 10% de profesionales formados (OR 1,21, IC 95% 1,01–1,45). Conclusiones: La formación incide positivamente en la técnica de higienización de manos especialmente en servicios quirúrgicos y profesionales médicos (AU)

Objetive: To identify factors related with the performance of a proper hand hygiene technique in a hand hygiene campaign. Methods: We developed two cross-sectional studies on 15 hospital units. The outcome variable was complied HH with proper technique and the exposures variables were care factors (unit, professional group, etc) and other factors related with the HH campaign (training on hand washing). Statistical analysis: The strength of association was measured using odds ratios (OR) with their 95% confidence interval (CI). Adjusting for confounders was performed using multiple logistic regression. Results: 12% of the observed 1241 hand hygiene were performed with proper technique. The strongest associated factors were ICUS (OR: 4.07 (CI 95% (1.95–8.51)), surgical wards (OR: 3.24 (CI 95% (1.52–6.92), procedures with high risk of contamination (OR: 2,56 CI 95% (1.34–4.70)), and physicians (OR: 2.52 CI 95% (0.93–6.85)). Training increased by 21% the probability of hand hygiene with proper technique for every 10% increase in trained health care workers (OR: 1.21 CI 95% (1.01–1.45). Conclusions: Hand Washing Training was associated with proper technique especially in surgical services and physicians (AU)

[Factors related with the performance of a proper hand hygiene]. / Factores asociados a la técnica correcta en la higiene de manos.

OBJECTIVE: To identify factors related with the performance of a proper hand hygiene technique in a hand hygiene campaign. METHODS: We developed two cross-sectional studies on 15 hospital units. The outcome variable was complied HH with proper technique and the exposures variables were care factors (unit, professional group, etc) and other factors related with the HH campaign (training on hand washing). STATISTICAL ANALYSIS: The strength of association was measured using odds ratios (OR) with their 95% confidence interval (CI). Adjusting for confounders was performed using multiple logistic regression. RESULTS: 12% of the observed 1241 hand hygiene were performed with proper technique. The strongest associated factors were ICUS (OR: 4.07 (CI 95% (1.95-8.51)), surgical wards (OR: 3.24 (CI 95% (1.52-6.92), procedures with high risk of contamination (OR: 2,56 CI 95% (1.34-4.70)), and physicians (OR: 2.52 CI 95% (0.93-6.85)). Training increased by 21% the probability of hand hygiene with proper technique for every 10% increase in trained health care workers (OR: 1.21 CI 95% (1.01-1.45). CONCLUSIONS: Hand Washing Training was associated with proper technique especially in surgical services and physicians.

Impacto de una campaña de mejora de la higiene de manos sobre el consumo de soluciones hidroalcohólicas en un hospital de tercer nivel / Impact of a hand hygiene campaign on alcoholic hand rub consumption in a tertiary hospital

ObjetivoValorar la influencia sobre el consumo de preparados de base alcohólica de una campaña de mejora de la higiene de manos, y más concretamente del desarrollo de talleres prácticos sobre higienización de manos en un hospital de tercer nivel del Servicio Cántabro de Salud.MétodosSe realizó un estudio ecológico con datos de enero de 2005 a diciembre de 2008. La variable dependiente fue el consumo de preparados de base alcohólica (ml/día). Como variable independiente se utilizó la campaña de mejora de la higiene de manos desarrollada en el Servicio Cántabro de Salud. Para valorar la relación del consumo con la campaña se utilizó un análisis de regresión lineal múltiple.Resultados y conclusionesDestaca la asociación entre la formación recibida sobre higiene de manos en las unidades de hospitalización y el consumo de preparados de base alcohólica, que mejora al consolidarse la campaña (año 2008) y demuestra un efecto positivo de ésta, en especial de sus aspectos formativos (AU)

ObjectiveTo evaluate the influence of a hand hygiene program on consumption of alcoholic hand rub, and specifically the impact of the development of hand washing training in a tertiary hospital belonging to the Cantabrian Health Service in Spain.MethodsWe performed an ecological study from January 2005 to December 2008. The dependent variable was consumption of alcoholic hand rub (ml/day). As the independent variable, we used the hand hygiene campaign developed by the Cantabrian Health Service. The relationship between alcoholic hand rub consumption and the campaign was evaluated using multiple linear regression.Results and conclusionsThe training received in hand hygiene in hospital wards was associated with consumption of alcoholic hand rub, which improved as the campaign became consolidated (in 2008) and showed a positive effect, particularly its training aspects (AU)

[Impact of a hand hygiene campaign on alcoholic hand rub consumption in a tertiary hospital]. / Impacto de una campaña de mejora de la higiene de manos sobre el consumo de soluciones hidroalcohólicas en un hospital de tercer nivel.

OBJECTIVE: To evaluate the influence of a hand hygiene program on consumption of alcoholic hand rub, and specifically the impact of the development of hand washing training in a tertiary hospital belonging to the Cantabrian Health Service in Spain. METHODS: We performed an ecological study from January 2005 to December 2008. The dependent variable was consumption of alcoholic hand rub (ml/day). As the independent variable, we used the hand hygiene campaign developed by the Cantabrian Health Service. The relationship between alcoholic hand rub consumption and the campaign was evaluated using multiple linear regression. RESULTS AND CONCLUSIONS: The training received in hand hygiene in hospital wards was associated with consumption of alcoholic hand rub, which improved as the campaign became consolidated (in 2008) and showed a positive effect, particularly its training aspects.

Evaluating the impact of a hand hygiene campaign on improving adherence.

We monitored compliance with hand hygiene (HH) by direct observation in 3 hospitals in Cantabria, Spain before and after implementation of an HH informational campaign, separately analyzing the effect of a training program. We report that training plus an informational campaign doubled the probability of HH, whereas the informational campaign without training decreased adherence, acting as a deleterious factor in HH adherence.