Investigating the clinical impact of procedural packs in secondary care

• Main Author: Callaghan, Liam
• Published: Ulster University 2016
• Subjects: 615
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.697544

Background: Clinical procedural packs were identified as an area of healthcare where an enhancement in design and implementation could improve practitioner performance and associated service user outcomes. Objectives: This study assessed the clinical impact of two interventions, (1) procedural packs with an enhanced training programme and (2) feedback system, on both blood culture sampling and PVC insertion procedures within Antrim Area Hospital. Study Design: A time series design study, using retrospective and prospective data, was used to evaluate impact of two interventions on complication rates associated with both procedures. Impact of the interventions was evaluated by comparing pre- and post- mean complication rates calculated through statistical process control p-chart analysis. Qualitative data gathered from practitioner focus group discussion and quantitative data from patient questionnaires further facilitated exploration of underlying issues. Results: A non-significant reduction in mean blood culture contamination rate was recorded from a Phase A baseline rate of 2.5%, with a reduction to 1.89% from Phase B intervention and to 1.47% from Phase C intervention, over a 30 month study, p = 0.066. However, regression analysis did show a significant downward trend of mean blood culture contamination rate over the 30 month study period, p = 0.015. A significant decrease in mean PVC clinical adverse event rates were recorded from a Phase A baseline rate of 12.84%, with a reduction to 9.48% from Phase B intervention (p = 0.008) and a further drop to 5.96% from Phase C intervention, over a 72 week study (p < 0.001). However, a high rate of PVC failures due to non-clinical adverse events was recorded through Phase A (22.30%), Phase B (31.80%) and Phase C (25.66%) of the study. Conclusions: The combination of best practice guidelines, procedural pack with an enhanced training programme and feedback system achieved and maintained optimal procedural practice.