Five-year sustainability of a de-implementation strategy to reduce inappropriate use of catheters: a multicentre, mixed-methods study
2024

Sustainability of a Strategy to Reduce Catheter Use

Sample size: 1340 publication Evidence: high

Author Information

Author(s): van Horrik Tessa M.Z.X.K., Verkerk Eva W., Geerlings Suzanne E., Kool Rudolf B., Laan Bart J.

Primary Institution: Amsterdam UMC, University of Amsterdam

Hypothesis

The reduction of inappropriate catheter use was maintained, even after the de-implementation efforts of the research team had stopped.

Conclusion

Inappropriate catheter use was still significantly lower five years after the implementation of a multifaceted de-implementation strategy.

Supporting Evidence

  • Five years after the de-implementation strategy, inappropriate PIVC use was reduced from 22% to 13.8%.
  • The main facilitator for reducing inappropriate catheters was intrinsic motivation to reduce catheter-associated infections.
  • Barriers included other priorities, lack of time, and not having a dedicated clinical champion.

Takeaway

This study shows that hospitals can keep using fewer unnecessary catheters for a long time if they follow a good plan.

Methodology

A multicentre mixed-methods study involving observational data collection and interviews in five hospitals.

Potential Biases

Potential bias from the Hawthorne effect and the exclusion of severely ill patients.

Limitations

Two hospitals were excluded due to organizational changes, and the study lacked appropriate numbers for a non-inferiority analysis.

Participant Demographics

Included 1340 patients, with a median age of 67 years, and a majority being male.

Statistical Information

P-Value

<0.001

Confidence Interval

95% CI 0.68 to 0.84

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1016/j.eclinm.2024.102785

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