Improvement of Broviac catheter-related outcomes after the implementation of a quality management system: A before-and-after prospective observational study

Manel Kammoun; Anouar Jarraya; Saloua Ammar; kamel Kolsi

doi:10.47338/jns.v12.1156

Authors

Manel Kammoun Hedi Chaker University Hospital, University of Sfax, Tunisia https://orcid.org/0000-0003-3909-1627
Anouar Jarraya Hedi Chaker University Hospital, University of Sfax, Tunisia
Saloua Ammar Hedi Chaker University Hospital, University of Sfax, Tunisia
kamel Kolsi Hedi Chaker University Hospital, University of Sfax, Tunisia

DOI:

https://doi.org/10.47338/jns.v12.1156

Keywords:

Broviac catheter, Quality process, Complications, Venous access

Abstract

Background: Because of the high rates of Broviac catheter complications, we started an urgent quality process to reduce this morbidity. The aim is to assess the efficiency of the main actions we have taken in enhancing our practice and improving Broviac outcomes.

Methods: We included all neonates and young infants requiring surgical central venous access using a Broviac tunneled catheter. We compared the catheters’ outcomes before and after the implementation of a quality program based on a nurse teaching program, patient selection, and catheter management multidisciplinary protocol. The significance threshold was set at p<0.05.

Results: We included 94 patients: 51 in the protocol group and 43 in the control group. The complication rate was reduced from 60.3% to 25.5% with p=0.001. The lifetime of the catheter was improved from 11.3 ± 4.3 days to 19.1 ± 9 days with p=0.007. The catheter infection was reduced from 65.3% to 46.1% with p≤0.001.

Conclusion: This quality improvement project shows the utility of a quality assurance program based on careful indications and patient selection, a nursing teaching program, and a multidisciplinary catheter management protocol, in reducing Broviac catheter-related morbidity.

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Author Biographies

Manel Kammoun, Hedi Chaker University Hospital, University of Sfax, Tunisia

Anesthesiology Department,

Anouar Jarraya, Hedi Chaker University Hospital, University of Sfax, Tunisia

Anesthesiology Department,

Saloua Ammar, Hedi Chaker University Hospital, University of Sfax, Tunisia

Pediatric Surgery Department,

kamel Kolsi, Hedi Chaker University Hospital, University of Sfax, Tunisia

Anesthesiology Department,

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