Camelia Bogaert, Anneleen De Greve, Charlotte Verfaillie
{"title":"护士主导的同行审计是改善周围静脉导管护理和减少血流感染的驱动因素。","authors":"Camelia Bogaert, Anneleen De Greve, Charlotte Verfaillie","doi":"10.1016/j.jhin.2026.04.013","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Peripheral intravenous catheters (PIVC) are widely used in acute care and are an important source of preventable peripheral line-associated bloodstream infections (PLABSI). Evidence on sustainable, nurse-led strategies to improve PIVC care and reduce PLABSI remains limited.</p><p><strong>Aim: </strong>To describe a longitudinal multimodal quality improvement strategy combining nurse-led peer audits and real-time digital feedback to improve PIVC care and reduce PLABSI in an acute care hospital.</p><p><strong>Methods: </strong>A longitudinal multimodal quality improvement strategy was conducted between June 2022 and December 2025 on adult internal medicine, surgical and geriatric wards in a Belgian acute secondary care hospital. Weekly bedside audits of PIVC care bundle elements were introduced, initially led by an infection prevention and control (IPC) nurse and later transitioned to a structured nurse-led peer audit model using a digital questionnaire. Audit data were visualised in interactive dashboards alongside surveillance data.</p><p><strong>Results: </strong>A total of 6,718 PIVC audits were performed. Compliance with directly observable bedside practices improved substantially, including insertion site visibility (12.7% in 2023 to >90% in 2024 and 2025) and dressing quality. Documentation- and time-dependent processes showed more limited improvement. PLABSI incidence declined progressively from 0.81 per 10,000 patient-days in 2022 to 0.29 in 2025. Several wards achieved sustained PLABSI-free periods exceeding 90 days.</p><p><strong>Conclusions: </strong>A nurse-led peer audit strategy supported by real-time digital feedback was associated with sustained improvement in PIVC care and reduction of PLABSI incidence. Embedded within a multimodal approach, this strategy enhanced ownership and actionable feedback. Further improvement may require targeted strategies addressing time-dependent processes.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Nurse-led peer audits as a driver for improved peripheral intravenous catheter care and reduced bloodstream infections.\",\"authors\":\"Camelia Bogaert, Anneleen De Greve, Charlotte Verfaillie\",\"doi\":\"10.1016/j.jhin.2026.04.013\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Peripheral intravenous catheters (PIVC) are widely used in acute care and are an important source of preventable peripheral line-associated bloodstream infections (PLABSI). Evidence on sustainable, nurse-led strategies to improve PIVC care and reduce PLABSI remains limited.</p><p><strong>Aim: </strong>To describe a longitudinal multimodal quality improvement strategy combining nurse-led peer audits and real-time digital feedback to improve PIVC care and reduce PLABSI in an acute care hospital.</p><p><strong>Methods: </strong>A longitudinal multimodal quality improvement strategy was conducted between June 2022 and December 2025 on adult internal medicine, surgical and geriatric wards in a Belgian acute secondary care hospital. Weekly bedside audits of PIVC care bundle elements were introduced, initially led by an infection prevention and control (IPC) nurse and later transitioned to a structured nurse-led peer audit model using a digital questionnaire. Audit data were visualised in interactive dashboards alongside surveillance data.</p><p><strong>Results: </strong>A total of 6,718 PIVC audits were performed. Compliance with directly observable bedside practices improved substantially, including insertion site visibility (12.7% in 2023 to >90% in 2024 and 2025) and dressing quality. Documentation- and time-dependent processes showed more limited improvement. PLABSI incidence declined progressively from 0.81 per 10,000 patient-days in 2022 to 0.29 in 2025. Several wards achieved sustained PLABSI-free periods exceeding 90 days.</p><p><strong>Conclusions: </strong>A nurse-led peer audit strategy supported by real-time digital feedback was associated with sustained improvement in PIVC care and reduction of PLABSI incidence. Embedded within a multimodal approach, this strategy enhanced ownership and actionable feedback. Further improvement may require targeted strategies addressing time-dependent processes.</p>\",\"PeriodicalId\":54806,\"journal\":{\"name\":\"Journal of Hospital Infection\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.1000,\"publicationDate\":\"2026-05-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hospital Infection\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.jhin.2026.04.013\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hospital Infection","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.jhin.2026.04.013","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Nurse-led peer audits as a driver for improved peripheral intravenous catheter care and reduced bloodstream infections.
Background: Peripheral intravenous catheters (PIVC) are widely used in acute care and are an important source of preventable peripheral line-associated bloodstream infections (PLABSI). Evidence on sustainable, nurse-led strategies to improve PIVC care and reduce PLABSI remains limited.
Aim: To describe a longitudinal multimodal quality improvement strategy combining nurse-led peer audits and real-time digital feedback to improve PIVC care and reduce PLABSI in an acute care hospital.
Methods: A longitudinal multimodal quality improvement strategy was conducted between June 2022 and December 2025 on adult internal medicine, surgical and geriatric wards in a Belgian acute secondary care hospital. Weekly bedside audits of PIVC care bundle elements were introduced, initially led by an infection prevention and control (IPC) nurse and later transitioned to a structured nurse-led peer audit model using a digital questionnaire. Audit data were visualised in interactive dashboards alongside surveillance data.
Results: A total of 6,718 PIVC audits were performed. Compliance with directly observable bedside practices improved substantially, including insertion site visibility (12.7% in 2023 to >90% in 2024 and 2025) and dressing quality. Documentation- and time-dependent processes showed more limited improvement. PLABSI incidence declined progressively from 0.81 per 10,000 patient-days in 2022 to 0.29 in 2025. Several wards achieved sustained PLABSI-free periods exceeding 90 days.
Conclusions: A nurse-led peer audit strategy supported by real-time digital feedback was associated with sustained improvement in PIVC care and reduction of PLABSI incidence. Embedded within a multimodal approach, this strategy enhanced ownership and actionable feedback. Further improvement may require targeted strategies addressing time-dependent processes.
期刊介绍：
The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience.
The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that:
provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings;
provide new insight into cleaning, disinfection and decontamination;
provide new insight into the design of healthcare premises;
describe novel aspects of outbreaks of infection;
throw light on techniques for effective antimicrobial stewardship;
describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control;
improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change;
improve understanding of the use of IT systems in infection surveillance and prevention and control.
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