Awareness, Experience and the Effectiveness of Education

Survey: Only 31% of nurses (whose job description included removal of central lines) reported using all the recommended procedures. (see here)

Nurses more aware than doctos of risks of air embolism on CVC removal (see here)

Air embolism entirely preventable complication, but not widely known among practitioners (see here)

Are we missing too many cases? (see here)

Nurse Survey. In overall group comparison, few differences were found between nurses and physicians in terms of patient positioning at CVC insertion or removal. Nurses were more likely than physicians to request air-occlusive dressings after CVC removal (19 of 53 [36%] vs. 12 of 140 [9%]; p < .001), but there was no difference between nurses and physicians in awareness of VAE as the reason for choosing one patient position or dressing over another (29% vs. 39%, respectively). Critical care nurses with <=2 years of experience more often placed the patient in the supine or the Trendelenburg position for CVC removal than nurses with >2 years of experience (71% vs. 26%; p = .03).

Although most physicians (127, 91%) chose the Trendelenburg position for CVC insertion, only 42 physicians (30%) reported concern for VAE. On CVC removal, only 36 physicians (26%) cited concern for VAE. Some physicians (13, 9%) reported elevating the head of the bed during CVC removal, possibly increasing the risk of VAE. Awareness of VAE or its prevention did not correlate with the level of physician training, experience, or specialty. After the educational intervention, concern for and awareness of proper methods of prevention of VAE improved (p < .001). At 6-month follow-up, reported use of the Trendelenburg position continued, but concern cited for VAE had returned to baseline. (see here)