Pilot project aimed at enhancing nursing skills for managing vascular access devices in the oncohematology setting

Venous vascular access devices (VAD) provide a safe route for drug administration but are not free from potential complications and failures. Proper training on their management is essential to reduce these events by ensuring staff adherence to current recommendations and guidelines. Correct management is crucial to ensure safe and effective care. However, the growing use of these devices has been accompanied by an increase in related complications.

To evaluate the effectiveness of an online training program (FAD) for nursing staff in reducing VAD failures (PICC, MiniMidline, Midline, PORT, and PICC-port) and improving theoretical knowledge of vascular access management.

A prospective observational three-phase study was conducted over 14 months (2022-2023) at the Onco-Hematology Department of IRCCS Ospedale Policlinico San Martino, Genoa. A total of 1098 patients undergoing VAD placement were included (532 pre-training and 562 post-training). The primary endpoint was the reduction in device failure, defined as any complication leading to removal. Incidence rates were compared between periods using an adjusted Poisson regression analysis. As a secondary objective, the effect of training on MiniMidline and Midline device performance was evaluated by including the interaction between training and device type in the model. Pre- and post-course test scores were also analyzed.

The overall failure rate did not show a statistically significant reduction (RR 0.87; 95% CI 0.59-1.26; p = 0.46). However, a significant reduction in Midline failure risk was observed after training (RR from 5.33 to 2.20; p < 0.001). Nurses' mean test scores significantly improved from 11.00 to 12.14 out of 15 (p < 0.001).

The online training program significantly improved nurses' theoretical knowledge and reduced complications related to Midline devices. However, to achieve a broader impact on VAD-associated complications, structured and continuous training programs are needed.