scholarly journals Developing, Implementing, and Evaluating a Multimedia Patient Decision Aid Program to Reform the Informed Consent Process of a Peripherally Inserted Central Venous Catheter Procedure: Protocol for Quality Improvement 

10.2196/10709 ◽  
2018 ◽  
Vol 7 (12) ◽  
pp. e10709 ◽  
Author(s):  
Azizeh Khaled Sowan ◽  
Arlienita R Beraya ◽  
Adrian Carrola ◽  
Charles C Reed ◽  
Sherrie V Matthews ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Informed Consent ◽  
Central Venous Catheter ◽  
Decision Aid ◽  
Venous Catheter ◽  
Informed Consent Process ◽  
Consent Process ◽  
Patient Decision Aid ◽  
Central Venous ◽  
Patient Decision

scholarly journals Developing, Implementing, and Evaluating a Multimedia Patient Decision Aid Program to Reform the Informed Consent Process of a Peripherally Inserted Central Venous Catheter Procedure: Protocol for Quality Improvement  (Preprint)

2018 ◽  
Author(s):  
Azizeh Khaled Sowan ◽  
Arlienita R Beraya ◽  
Adrian Carrola ◽  
Charles C Reed ◽  
Sherrie V Matthews ◽  
...  
Keyword(s):  
Informed Consent ◽  
Assessment Tool ◽  
Venous Catheter ◽  
Consent Process ◽  
Invasive Procedures ◽  
Central Venous ◽  
Patient Centered ◽  
Multimedia Program ◽  
Patient Decision ◽  
Change Team

BACKGROUND Informed consent has considerable clinical, ethical, and legal implications for patient safety and liability. Little information is available about the use of multimedia patient decision aids (PtDA) in the consent process for therapeutic invasive procedures such as the peripherally inserted central venous catheter (PICC). In addition, none of the available studies have designed their multimedia PtDAs based on the Agency for Healthcare Research and Quality’s (AHRQ) comprehensive guide for informed consent. OBJECTIVE This paper describes a patient-centered, systematic, multidisciplinary approach to develop, implement, and alpha test a multimedia PtDA to reform the informed consent process of a PICC for patients in 10 acute and intensive care units. METHODS The development, implementation, and evaluation processes of the PtDA followed the phases in the Multimedia Production Framework: preproduction, production, and postproduction. Within this framework, we applied the criteria for judging the quality of PtDAs, the AHRQ’s Health Literacy Universal Precautions Toolkit, and the AHRQ’s Patient Education Materials Assessment Tool Guide. The methodology was guided by the Interprofessional Shared Decision-Making Model and the AHRQ’s Making Informed Consent an Informed Choice guide. In the preproduction phase, we (1) reviewed the current consent form; (2) observed 18 consent processes; (3) surveyed the vascular access team (N=6 nurses) about their perception of the current process; (4) surveyed 30 patients for knowledge recall and retention, overall satisfaction, and attitude toward using a multimedia PtDA; and (5) wrote and reviewed the script for the multimedia program. The production phase focused on filming the PtDA in English and Spanish languages. The postproduction phase included integrating the multimedia programs into the care processes, developing a modified workflow for the consent process, and alpha testing of the English and Spanish PtDAs by (1) a group of 5 patients for clarity and understandability of the information; (2) nurses using the AHRQ’s Patient Education Materials Assessment Tool Audio and Video; and (3) by the multidisciplinary change team. RESULTS Based on the alpha testing, patients indicated that the content was easy to follow and read; nurses provided positive feedback, and their comments were mainly related to the changes in the workflow in the consent process of the PICC after using the PtDA; and the multidisciplinary change team suggested edits related to changing a few scenes. The final multimedia program consisted of 7 min and 37 s demonstrating detailed information about the PICC. CONCLUSIONS A systematic development of PtDAs for nonurgent invasive procedures may eliminate many limitations of the conventional consent process by ensuring comprehensive, standardized, and easy-to-comprehend information and providing sufficient time for the patients to reflect on the information. To be effective, PtDAs should follow a systematic, patient-centered, evidence-based, and rigorous approach in the development, implementation, and evaluation processes. INTERNATIONAL REGISTERED REPOR RR1-10.2196/10709

scholarly journals Reducing Central Venous Catheter Use in Peripheral Blood Stem Cell Donation: Quality Improvement Report

2017 ◽  
Vol 6 (1) ◽  
pp. u211975.w4817
Author(s):  
Samer Ghazi ◽  
Ahmed Alaskar ◽  
Mohsen Alzahrani ◽  
Moussab Damlaj ◽  
Khadega A Abuelgasim ◽  
...  
Keyword(s):  
Stem Cell ◽  
Quality Improvement ◽  
Central Venous Catheter ◽  
Peripheral Blood ◽  
Peripheral Blood Stem Cell ◽  
Venous Catheter ◽  
Blood Stem Cell ◽  
Central Venous ◽  
Stem Cell Donation

scholarly journals Effect of a Multimedia Patient Decision Aid to Supplement the Informed Consent Process of a Peripherally Inserted Central Venous Catheter Procedure: Pre-Post Quasi-Experimental Study (Preprint)

2018 ◽  
Author(s):  
Azizeh K Sowan ◽  
Arlienita R Beraya ◽  
Adrian Carrola ◽  
Charles Reed
Keyword(s):  
Experimental Study ◽  
Patient Satisfaction ◽  
Intervention Group ◽  
Venous Catheter ◽  
Knowledge Retention ◽  
Consent Process ◽  
Control Group ◽  
Central Venous ◽  
Patient Decision ◽  
Quasi Experimental

BACKGROUND Informed consent is a complex process to help patients engage in care processes and reach the best treatment decisions. There are many limitations to the conventional consent process that is based on oral discussion of information related to treatment procedures by the health care provider. A conclusive body of research supports the effectiveness of multimedia patient decision aids (PtDAs) in the consent process in terms of patient satisfaction, increased knowledge about the procedure, reduced anxiety level, and higher engagement in the decision making. Little information is available about the effectiveness of multimedia PtDAs in the consent process of invasive therapeutic procedures such as the peripherally inserted central venous catheter (PICC). OBJECTIVE The objective of this study was to examine the effectiveness of a multimedia PtDA in supplementing the consent process of the PICC for patients in 10 acute and intensive care units in terms of knowledge recall, knowledge retention, satisfaction with the consent process, and satisfaction with the PICC multimedia PtDA. METHODS This pre-post quasi-experimental study included 130 patients for whom a PICC was ordered. Patients in the control group (n=65) received the conventional consent process for the PICC, while those in the intervention group (n=65) received the multimedia PtDA to support the consent process of a PICC. All patients were surveyed for knowledge recall and retention about the procedure and satisfaction with the consent process. Patients in the intervention group were also surveyed for their satisfaction with the multimedia PtDA. RESULTS Compared with the control group, patients in the intervention group scored around 2 points higher on knowledge recall (t125=4.9, P<.001) and knowledge retention (t126=4.8, P<.001). All patients in the intervention group were highly satisfied with the multimedia PtDA, with a mean score of >4.5 out of 5 on all items. Items with the highest mean scores were related to the effect of the multimedia PtDA on knowledge retention (mean 4.9 [SD 0.2]), patient readiness to learn (mean 4.8 [SD 0.5]), complete understanding of the procedure-related complications (mean 4.8 [SD 0.4]), and patient role in maintaining the safety of the PICC (mean 4.8 [SD 0.5]). Patients in the two groups were highly satisfied with the consent process. However, 15% (10/65) patients in the control group reported that the following information was omitted from the discussion: patient and provider roles in the safety of the PICC, other treatment options, and common side effects. Furthermore, 2 patients commented that they were not ready to engage in the discussion. CONCLUSIONS The multimedia PtDA is an effective standardized, structured, self-paced learning tool to supplement the consent process of the PICC and improve patient satisfaction with the process, knowledge recall, and knowledge retention.

CE Article: A Quality Improvement Approach in Standardizing Pediatric Central Venous Catheter Dressings and Its Impact on the Reduction of Central Line-Associated Bloodstream Infections and Costs

2019 ◽  
Vol 24 (2) ◽  
pp. 11-19
Author(s):  
Christopher Kramer ◽  
Darcy Doellman ◽  
Casey Blaser ◽  
Robin Huneke Rosenberg ◽  
Stéphanie F. Bernatchez
Keyword(s):  
Quality Improvement ◽  
Central Venous Catheter ◽  
Pediatric Patients ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Central Line ◽  
Central Venous ◽  
Clabsi Rate

Highlights A CVC dressing inventory is beneficial to pediatric patients. Dressing standardization reduced unplanned dressing changes and costs. In our study, the new dressing inventory helped reduce the CLABSI rate.

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