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Published on: April 19, 2019
Implementation of a multimodal strategy via a mobile application to reduce catheter failure in patients with vascular
Jesús Bujalance-Hoyos1,2, Margarita Enríquez de Luna-Rodríguez3, Ana Carmen González-Escobosa1
1Hospital Regional Universitario de Málaga, 29009, Málaga, Andalusia, Spain.
Insights
A mobile app intervention significantly reduced vascular access device failures and catheter-related bloodstream infections (CRBSIs). This digital health tool improved patient knowledge and satisfaction while lowering healthcare costs associated with complications.
Area of Science:
- Medical Informatics
- Infection Control
- Nursing Practice
Background:
- Vascular access devices (VADs) are crucial for intravenous therapy, but complications like catheter-related bloodstream infections (CRBSIs) increase morbidity and mortality.
- Billions of VADs are used globally, necessitating effective strategies to mitigate associated risks and healthcare costs.
Purpose of the Study:
- To evaluate the impact of the CUIDAVEN mobile application on reducing VAD failures and CRBSI-related costs.
- To assess improvements in nurses' adherence to best practices for vascular access care using a digital intervention.
Main Methods:
- A quasi-experimental pre-post intervention study was conducted from April 2019 to August 2022.
- Adult patients requiring VADs, capable of using a mobile app, were included; those with cognitive impairment were excluded.
- The CUIDAVEN app provided educational resources, reminders, and monitoring tools for VAD care.
Main Results:
- Catheter failure rate decreased by 19.42%, and CRBSIs were reduced by 80%.
- Mean cost per complication significantly decreased from €310.66 to €118.79 (p=0.007).
- Adherence to best practices improved, and patients reported increased knowledge and satisfaction.
Conclusions:
- The CUIDAVEN mobile application effectively reduced infectious and non-infectious complications related to VADs.
- Digital health tools show potential in empowering patients and enhancing adherence to recommended practices.
- The study highlights the value of mobile applications in improving VAD care and patient outcomes.
Background:
Two billion vascular access devices (VADs) are used each year worldwide for the administration of intravenous therapy. Among the most serious complications are catheter-related bloodstream infections (CRBSIs), which increase morbidity and mortality and reduce patients' quality of life. The aim of this study was to evaluate the impact of implementing a multimodal intervention through a mobile application (CUIDAVEN, Nursing-led Vascular Access Care) on reducing catheter failure and the healthcare costs associated with CRBSIs, while improving nurses' adherence to best practice recommendations for vascular access care.
Methods:
We conducted a quasi-experimental pre-post intervention study without a control group, from April 2019 to August 2022, at the Hospital Regional University of Málaga (Spain). Adult patients requiring VADs (short peripheral intravenous catheters, midlines, peripherally inserted central catheter, and centrally inserted central catheters) for intravenous therapy and capable of using a mobile application were included. Patients with cognitive impairment or in a terminal condition were excluded. The intervention involved the use of the CUIDAVEN mobile application, which provided educational resources, reminders, and monitoring tools. Data were collected during the pre- and post-intervention phases. Variables analysed included sociodemographic characteristics, adherence to good practices, health outcomes, and resource consumption.
Results:
A total of 378 patients and 968 VADs were analysed. Catheter failure rate decreased by 19.42% in the post-intervention phase (from 16.95% to 12.24%), with an 80% reduction in CRBSIs (from 2.30% to 0.61%). Mean cost per complication fell from €310.66 to €118.79 (p=0.007). Significant improvements were observed in adherence to best practices. Patients also reported increased knowledge and satisfaction with the use of CUIDAVEN.
Conclusions:
The implementation of the CUIDAVEN mobile application was associated with a reduction in both infectious and non-infectious complications and improved adherence to recommended practices. Patients perceived greater knowledge and satisfaction, highlighting the potential of digital health tools to empower individuals and improve health outcomes.
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