Consensus on safety skills for patients with central venous catheters: a modified Delphi method

Central venous catheters (CVCs) are widely used and can lead to complications such as infection and thrombosis. These complications can result in longer hospital stays and increased healthcare costs. Although it has been demonstrated that patient education is effective, there is still no uniform competency framework in place for patients with CVCs.

In this study, we used a modified Delphi method to reach a consensus on the skills that patients with CVCs in an ambulatory setting should acquire through an educational intervention. The initial questionnaire submitted to the panel was based on a preliminary non-systematic literature review and included 12 competencies categorised into three themes: general information, daily life, and care. Ultimately, all competencies were categorised according to the World Health Organization guidelines: knowledge of the CVC, self-management skills for the patient's condition and confidence.

Consensus was reached on 22 competencies after two rounds involving 62 professionals. One interviewed healthcare professional had previously received medical care that included CVC insertion. A high level of consensus (≥90%) was reached for 15 of them. In the first round, all the experts validated three major competencies. Some competencies, such as identifying CVC connectors, proved controversial due to the potential risk of information overload for patients. Some experts also expressed concern about educating patients to report non-compliance regarding peripherally inserted central catheter maintenance to healthcare providers, fearing that this could damage the trust between patients and caregivers.

Despite some limitations, the competency framework that has been developed can be used as a reference for educational interventions aimed at reducing complications related to CVCs.