Impact of the RNAO Vascular Access Guideline, implemented within a BPSO program, on phlebitis in patients with peripheral catheters in subacute care
Eugenia Patricia Blanco Betes, Sendoa Ballesteros PeñaABSTRACT
Aim:
This study described the implementation of the Registered Nurses’ Association of Ontario ® (RNAO) Vascular Access Best Practice Guideline in a hospital in the Basque health system and evaluated its impact on vascular access care by comparing changes in phlebitis rates before and after implementation.
Methods:
A longitudinal pre-post observational study was conducted using routinely collected data on peripheral venous catheters from 2020 to 2023. A retrospective analysis of prospectively collected institutional data was performed. To describe the implementation process, implementation logs were reviewed, including meeting minutes, audit reports, and internal monitoring documents. Data on peripheral venous catheter insertions and phlebitis cases were extracted from the hospital's clinical data system. Annual phlebitis rates were calculated and compared using the
Results:
The implementation process followed the RNAO Best Practice Guideline Implementation Toolkit and was structured around three components: knowledge dissemination, professional training, and changes in clinical practice. A total of 3,272 peripheral venous catheter insertions was recorded in 2020 and 1,210 insertions in 2023. The phlebitis rate in 2020 was 6.3% (95% CI: 5.5%–7.2%), and decreased to 3.9% (95% CI: 2.9%–5.2%) in 2023, representing a statistically significant reduction and reaching values below the 5% threshold recommended by the Infusion Nurses’ Society.
Conclusions:
The implementation of the RNAO Vascular Access Guideline was associated with a statistically and clinically significant reduction in phlebitis rates. These findings support the use of structured implementation strategies in improving vascular access care.
Spanish abstract:
http://links.lww.com/IJEBH/A612