Epidemiology and Impact of Staff Training in Controlling Complications Related to Central Venous Catheters in 4 Intensive Care Units in a French University Hospital: Protocol of a Prospective, Quasi-Experimental, Before-After Study
Notice bibliographique
Résumé
BACKGROUND: Central venous catheters (CVCs) are essential tools in the management of critically ill patients in intensive care units (ICUs). However, their use is associated with several preventable complications, including central line-associated bloodstream infections (CLABSIs), catheter-related thrombosis, and mechanical events (eg, occlusion and rupture). Despite the availability of evidence-based guidelines from the French Society of Hospital Hygiene for CVC insertion and maintenance, adherence variability persists across health care settings, contributing to prolonged hospitalization, increased morbidity and mortality, and even increased health care costs. In 2022, an audit conducted at Edouard Herriot Hospital (Hospices Civils de Lyon, Lyon, France) revealed a degree of variation in adherence to current protocols. Specific deficits were noted in practices such as hand hygiene, flushing procedures, and aseptic techniques, among others. OBJECTIVE: This study aims to (1) evaluate the effectiveness of a multifaceted educational intervention in improving health care workers' adherence to national CVC management guidelines; (2) assess changes in complication rates (CLABSIs, thrombosis, and mechanical events) and patient outcomes (readmissions and mortality); and (3) identify factors associated with CVC-related complications through multivariate analysis. METHODS: We are conducting a prospective, quasi-experimental, before-after study in 4 adult ICUs at a French university hospital. The protocol includes preintervention and postintervention audits using a digital tool to capture real-time compliance data, as well as standardized educational sessions based on French Society of Hospital Hygiene recommendations. The intervention consists of face-to-face training, posters, and digital reminders, all delivered by the same team to ensure consistency. Clinical data include demographics, comorbidities, CVC type and duration of use, administered medications, and complications. All patients with CVCs, including centrally inserted catheters (jugular or subclavian), femoral lines, and peripherally inserted central catheters, are eligible. The primary outcome is the incidence rate of CVC-related complications per 1000 catheter-days. Secondary outcomes include rates of hospital readmission, ICU and in-hospital mortality, and the degree of improvement in guideline adherence across participating units. RESULTS: As of submission, 640 patients have been included in the study. Data collection remains ongoing. Data entry and final statistical analyses are expected to be completed in the third quarter of 2025. CONCLUSIONS: By combining audits, education, and feedback, this study will provide key insights into the effectiveness of education-based interventions for improving CVC-related practices in critical care settings. It may serve as a scalable model for enhancing patient safety and care quality in ICU settings. Results will be disseminated through peer-reviewed publications and international conferences. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/74985.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,011 | 0,009 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,003 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,003 | 0,003 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,003 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».