Learn easy way to track catheter complications
February 1, 1998 4 minutes read
Learn easy way to track catheter complications
Hospital works with home infusion providers
With the often fragmented and striated levels of care many patients receive, it can be difficult to track catheter complications as patients move from one care setting or provider to another. Sometimes, getting very different organizations to communicate with one another is downright impossible. Yet, accreditation organizations and referral sources will likely require such information soon, if they’re not requesting it already. Is there an easy way to collect catheter data for patients who don’t stay with your company?
A simple data collection form developed by the infusion therapy coordinator at a hospital may be your answer.
Joyce Chedester, RN, CRNI, IV therapy coordinator for Monongalia General Hospital in Morgantown, WV, says creating a data collection tool was a necessity in trying to improve patient care. "This helps us know what has happened with our lines, and we can make better decisions about the lines we put in so they’re not going to have as many complications," says Chedester. "We want to work with agencies, so when we send someone out with a line we can be sure it’s not only the appropriate line, but it is a workable line."
The hospital’s form, "Midline/Peripherally Inserted Central Catheter Surveillance Survey," has been in use for the past year. (See form, inserted in this issue, and policy and procedure, p. 21.) While the feedback from the survey has been less than Chedester had initially hoped, she says the information being collected has been extremely beneficial.
"We get 10% to 15% [of the forms] back, which is not really good, but it’s a start," says Chedester. "It’s more information than what we were getting. At least I have some way now that allows me to call and do the follow-up."
Using form is time-efficient
She says that after following up with a phone call, she gets 90% of the information she needs. Total time spent collecting the data works out to about 20 minutes per patient, which has already proven to be time well spent.
"We’re looking primarily for information about what kind of complications have occurred," says Chedester. "I haven’t pulled all the data together, but we have found certain lines that are breaking, such as the First PICC lines, so we’ve begun to use different products."
While there have been few instances of occluded catheters or infections, Chedester is in the process of developing internal levels for infection control.
The surveillance form and the surveillance survey policy are given to each agency that receives a Monongalia patient with a PICC line or midline. The form is sometimes mailed, although some home health agencies have nurses who regularly visit the hospital, and these nurses have mailboxes in the social services department. The form is accompanied by a cover letter that states the following:
In order that the follow-up of patients with PICC lines and midlines be coordinated between the IV nurses inserting the lines and the caregivers outside of the hospital, a form and guidelines for its use have been developed.
It is our intent to provide information concerning the line that will enable you to manage the line as needed and to document outcome information that JCAHO will be surveying.
Please review the documents included, and call me if there are any questions [(304) 598-1443]. I had the privilege of sharing this with some of you recently, and now that we’re ready to implement the system, I hope to continue being in touch with you.
Agencies that have worked with Monongalia in the past receive the surveillance form only.
Chedester finds that certain types of agencies are better about returning information:
• Local care providers.
"I get more response from the local agencies than from outlying nursing homes or home health agencies," she says. "There are local home health and nursing homes that have been cooperative, but if we send anybody more than 50 miles away, I don’t get the form back."
• Its affiliated home health agency.
Two years ago, Monongalia General started its own home care agency, which later became a separate entity jointly owned by Monongalia General and another Morgantown hospital. This agency has been very cooperative in getting information back but not necessarily because of the business connection.
"I’ve gotten good cooperation from them, but it’s because they’re people I know, and they are familiar with the form and why I need the information."
• Home health agencies in general.
Chedester says nursing homes are generally the least cooperative in getting information back to her.
"I think it’s a lack of knowledge, not that they don’t want to be cooperative," she says. "And sometimes nobody knows what happened to the form, so I may not be sending it to the right people."
Discuss form before mailing it
Chedester also notes that she gets a better response from agencies with which she has previously discussed the surveillance form.
"If I can talk with them about why it’s important, I get the information back," she says. Her tip for any other care provider tracking such information is to lay a solid foundation before you begin.
"Before I did this again, I would do a little more homework about all the agencies a patient could go to," says Chedester. "I found a much wider geographic area than I ever perceived we would be sending patients to. I would then try to get some advance information out to home health agencies, which is not how we were doing it originally."
Last year the hospital’s social services department held an inservice for area home health providers. Chedester was able to get her form on the agenda, which increased awareness among those home care providers in attendance.
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