Impact of educational interventions provided to patients with a central venous catheter and their informal caregivers: a systematic review.

Abstract

Background: Central venous catheters offer considerable benefits, but their presence can expose patients to serious complications. Preventing such complications is crucial, not only for individual patients, but also for hospitals and the healthcare system.

Objective: To assess the impact of educational interventions on clinical and non-clinical outcomes provided to patients with central venous catheters and/or their informal caregivers, regardless of the therapeutic indication, and to define the specific characteristics of effective educational strategies.

Methods: Medline and Embase were searched, covering all publications since their inception to 13 August 2024. Articles on clinical and/or non-clinical outcomes related to the education of patients with central venous catheters and their informal caregivers were included. Studies focusing solely on the education of healthcare providers were excluded. The reference lists of included studies were hand searched for additional citations. This systematic review followed PRISMA guidelines and the protocol was registered in PROSPERO (CRD42024577193). The quality of the included studies was assessed using the Mixed Methods Appraisal Tool.

Results: In total, 20 articles, representing 974 patients and 875 informal caregivers, were included in the review: seven randomized trials, ten quantitative studies without randomization, and three descriptive quantitative studies. The compliance rate of 60% for the randomised trials determined using the Mixed Methods Appraisal Tool indicates a low risk of bias, whereas non-randomised and descriptive quantitative studies show more methodological weaknesses (40% and 45%, respectively). There was a positive trend, significant or not, for the impact of patient education on reducing complications, particularly those related to infection (85% of the studies concerned by this outcome). This was often observed (64%) in studies based on educational interventions repeated over time. Studies that showed a significant improvement in patients' knowledge and skills in terms of self-management showed beneficial results in terms of the occurrence of complications. Nurses were the most common educators (15/20), and the most frequently used tools were written materials and digital resources, often combined with other methods for greater effectiveness.

Conclusions: This systematic review encourages the implementation of educational interventions for patients with central venous catheters and their informal caregivers, notably to decrease infections. Providing them with written documents and digital tools, and delivering them repeatedly over time, should be promoted. However, study heterogeneity limits definitive conclusions. Future research should standardize methodologies, involve patients in intervention design, and assess cost-effectiveness to ensure sustainable implementation.